BACKGROUND: Endoscopic evaluation serves both diagnostic and therapeutic purposes. With technological advancements, many gastrointestinal conditions that previously required surgical intervention can now be managed endoscopically. However, in most resource-limited settings, endoscopy services remain predominantly diagnostic. This study aimed to evaluate a decade of therapeutic endoscopy practice at a large endoscopic center in Addis Ababa, Ethiopia, highlighting its feasibility and benefits in a Sub-Saharan African context.

METHOD: An institution-based cross-sectional study was conducted to assess the patterns and practice of therapeutic endoscopy at Adera Medical and Surgical Center, Addis Ababa, Ethiopia, from October 2013 to September 2023. Socioeconomic, clinical, and endoscopic data were collected and analyzed using SPSS version 26.0.

RESULTS: Of the 48,550 endoscopic procedures performed, 2,393 (4.9%) were therapeutic. The mean age of patients was 42.5 ± 13.8 years, and 73.6% were male. The most common procedures were esophageal variceal ligation (68.6%), followed by polypectomy (8.4%), achalasia/stricture dilation (8.0%), hemorrhoid banding (6.6%), sclerotherapy (4.3%), cyanoacrylate injection (1.6%), foreign body removal (1.4%), adrenaline injection (0.9%), and hemoclip application (0.2%). Endoscopic intervention achieved immediate hemostasis in all upper gastrointestinal bleeding cases except for one patient with a bleeding duodenal ulcer who required surgical intervention after failed endoscopic sclerotherapy. Symptomatic relief was achieved in 100% of achalasia cases and 97.0% of stricture dilation cases. Foreign body removal was successful in 96.96% of cases, and all polyps were successfully managed endoscopically.

CONCLUSION: Therapeutic endoscopy is both feasible and effective in our setting. Expanding such services can significantly reduce the need for surgical interventions and improve gastrointestinal care in similar settings across Sub-Saharan Africa.

KEYWORDS: Therapeutic endoscopy; Gastrointestinal endoscopy; Endoscopic intervention; Ethiopia