A comparative study of unsedated transnasal esophagogastroduodenoscopy and conventional EGD

Dean, Robert S.; Dua, Kulwinder S.; Massey, Benson T.; Berger, William; Hogan, Walter J.; Shaker, Reza

doi:10.1016/s0016-5107(96)70092-5

Cited by 131 publications

(81 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent advances in the field of flexible bronchoscopy have given gastroenterologists the option of using a transnasal approach for EGD. 9 Ultrathin transnasal endoscopies have been designed to make the endoscopic examination more comfortable and safer. 11 It has been debated whether the best way to perform EGD is the transnasal or the transoral route.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of transnasal EGD (T-EGD) over C-EGD include absence of pharynx stimulation, no reactive gagging and vomiting reflexes, no risk of aspiration, the possibility for the examinee to speak during the examination, and unsedated endoscopy. [7][8][9][10] In this study, we focused on factors that influence the preference for T-EGD. We investigated the feasibility and tolerance of T-EGD and to the examinee and endoscopist factors that should be considered when choosing the modality of upper GI examination in a general medical checkup.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Transnasal Esophagogastroduodenoscopy as a Surveillance Endoscopy in a General Medical Checkup

Lee

Kim

et al. 2014

Korean J Helicobacter Up Gastrointest Res

View full text Add to dashboard Cite

Background/Aims: Transnasal esophagogastroduodenoscopy (T-EGD) has been reported to be well tolerated and is known to reduce patient discomfort that occurs with conventional EGD (C-EGD) performed via an oral route. We aimed to evaluate factors that influence preferences for T-EGD as a surveillance EGD in a general medical checkup. Materials and Methods: A total of 658 subjects (median age, 49 years; 45% men) underwent T-EGD procedures by 8 endoscopists using a 5.2-mm diameter endoscope. All examinees and endoscopists were asked to assess the T-EGD examinations using the post-endoscopy questionnaire. The post-endoscopy questionnaire included a 10-point visual analogue scale, which asked the patient to place a cross on the line according to examinee's or endoscopist's experience of the endoscopy procedure. Zero represented the worst experience and 10 the best experience. Results: T-EGD was feasible in 96.6% of the subjects. Younger age (＜35 years) and female sex were significant predictive factors for failure of the procedure. Older age (≥35 years) or male examines preferred T-EGD as the modality for the next examination. The endoscopist's overall discomfort level was higher in the beginner group than in the expert group. Conclusions: The T-EGD may be better tolerated than C-EGD and offers a more comfortable surveillance endoscopic procedure to older (≥35 years), male, or sedated C-EGD-experienced examinees in a general medical checkup. More experience with and education about T-EGD may help to improve the tolerance of the beginner group of endoscopists.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Transnasal Esophagogastroduodenoscopy as a Surveillance Endoscopy in a General Medical Checkup

Lee

Kim

et al. 2014

Korean J Helicobacter Up Gastrointest Res

View full text Add to dashboard Cite

show abstract

“…It is still debated whether the best way of introduction of these instruments is the transnasal or the peroral route, as until now few comparisons have been published in literature. Some randomized trials sug gested that the peroral route may be easier to perform and slightly preferred by both patients and endoscopists [17][18][19][20] . Conversely, in our series TN-EGD caused less discomfort and was better tolerated.…”

Section: Discussionmentioning

confidence: 99%

Unsedated ultrathin upper endoscopy is better than conventional endoscopy in routine outpatient gastroenterology practice: A randomized trial

Trevisani

Cifalà²,

Sartori³

et al. 2007

WJG

View full text Add to dashboard Cite

AIM: to compare the feasibility and patients' tolerance of esophagogastroduodenoscopy (EGD) using a thin endoscope with those of conventional oral EGD and to determine the optimal route of introduction of smallcaliber endoscopes. METHODS:One hundred and sixty outpatients referred for diagnostic EGD were randomly allocated to 3 groups: conventional (C)-EGD (9.8 mm in diameter), transnasal (TN)-EGD and transoral (TO)-EGD (5.9 mm in diameter). Pre-EGD anxiety was measured using a 100-mm visual analogue scale (VAS). After EGD, patients and endoscopists completed a questionnaire on the pain, nausea, choking, overall discomfort, and quality of the examination either using VAS or answering some questions. The duration of EGD was timed. Blood oxygen saturation (SaO2) and heart rate (HR) were monitored during EGD. RESULTS:Twenty-one patients refused to participate in the study. The 3 groups were well-matched for age, gender, experience with EGD, and anxiety. EGD was completed in 91.1% (41/45), 97.5% (40/41), and 96.2% (51/53) of cases in TN-EGD, TO-EGD, and C-EGD groups, respectively. TN-EGD lasted longer (3.11 ± 1.60 min) than TO-EGD (2.25 ± 1.45 min) and C-EGD (2.49 ± 1.64 min) (P < 0.05). The overall tolerance was higher (P < 0.05) and the overall discomfort was lower (P < 0.05) in TN-EGD group than in C-EGD group. EGD was tolerated "better than expected" in 73.2% of patients in TN-EGD group and 55% and 39.2% of patients in TO-EGD and C-EGD groups, respectively (P < 0.05). Endoscopy was tolerated "worst than expected" in 4.9% of patients in TN-EGD group and 17.5% and 23.5% of patients in TO-EGD and C-EGD groups, respectively (P < 0.05). TN-EGD caused mild epistaxis in one case. The ability to insufflate air, wash the lens, and suction of the thin endoscope were lower than those of conventional instrument (P < 0.001). All biopsies performed were adequate for histological assessment. CONCLUSION:Diagnostic TN-EGD is better tolerated than C-EGD. Narrow-diameter endoscope has a level of diagnostic accuracy comparable to that of conventional gastroscope, even though some technical characteristics of these instruments should be improved. Transnasal EGD with narrow-diameter endoscope should be proposed to all patients undergoing diagnostic EGD.

show abstract

“…[15][16][17] The major advantage of TNO is that it can be performed without the need for intravenous sedation or general anaesthesia, which is required for oesophagogastroduodenoscopy or rigid endoscopy respectively. This has profound implications as both sedation and anaesthesia carry significant risks; it is estimated that 0.6% of patients receiving sedation develop a cardiopulmonary event.…”

Section: Sanyaolu Jemah Stew Ingrams the Role Of Transnasal Oesophagomentioning

confidence: 99%

The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia

Jemah

Stew

2016

annals

View full text Add to dashboard Cite

INTRODUCTION Transnasal oesophagoscopy is a relatively new method of examining the upper aerodigestive tract via the nasal passage as an outpatient procedure without the need for sedation. It has been shown to be a well tolerated, safe and accurate technique, that can therefore be used in the investigation of patients thought to have globus pharyngeus and other non sinister causes of dysphagia. METHODS A total of 150 consecutive patients undergoing transnasal oesophagoscopy were analysed retrospectively. RESULTS The main indications for this procedure were non-progressive dysphagia (n=68, 45%) and globus pharyngeus (n=60, 40%). Transnasal oesophagoscopy was normal in 65% of patients and 42% of patients were discharged from clinic at the same appointment with no further investigation. The most common positive findings were laryngeal erythema (13%) and oesophagitis (10%). CONCLUSIONS Transnasal oesophagoscopy is a useful adjunct to the management of patients with the symptoms of globus pharyngeus and non-progressive dysphagia.

show abstract

A comparative study of unsedated transnasal esophagogastroduodenoscopy and conventional EGD

Cited by 131 publications

References 10 publications

Evaluation of Transnasal Esophagogastroduodenoscopy as a Surveillance Endoscopy in a General Medical Checkup

Evaluation of Transnasal Esophagogastroduodenoscopy as a Surveillance Endoscopy in a General Medical Checkup

Unsedated ultrathin upper endoscopy is better than conventional endoscopy in routine outpatient gastroenterology practice: A randomized trial

The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia

Contact Info

Product

Resources

About