A Prospective Randomized Comparative Study on the Safety and Tolerability of Transnasal Esophagogastroduodenoscopy

Yagi, Jin; Adachi, Kyoichi; Arima, Naosuke; Tanaka, Shu; Ose, Takayuki; Azumi, Takayoshi; Sasaki, Hiroshi; Sato, Motonori; Kinoshita, Y.

doi:10.1055/s-2005-921037

Cited by 89 publications

(96 citation statements)

References 7 publications

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“…According to other trials [21,29] , in our study the percentage of abnormal vital signs was similar in the three groups of patients. However, it has recently been reported that TN-EGD is associated with fewer adverse effects on cardiopulmonary function than TO-EGD [30] . Our study confirmed that the performances of the narrow endoscope were acceptable.…”

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

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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.

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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

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“…Although manometric methods, scintigraphic methods, electrogastrography and ultrasonography have been used to evaluate enterokinesis, a practical method for evaluating duodenal hypersensitivity to acid has not been reported. Transnasal endoscopy is a rescently developed, non-invasive and nondiscomforting method for examination of the upper gastrointestinal tract (Yagi et al, 2005;Murata et al, 2007). We developed a new method for evaluating duodenal hypersensitivity to acid and gastric motility by duodenal acidification using transnasal endoscopy (Ishii et al, 2008).…”

Section: New Methods For Evaluating Duodenal Hypersensitivity To Acid mentioning

confidence: 99%

Duodenal hypersensitivity to acid in patients with functional dyspepsia-pathogenesis and evaluation

Ishii

Kusunoki

Manabe

et al. 2010

J Smooth Muscle Res

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Functional dyspepsia (FD) is a subcategory of the functional gastrointestinal disorders according to the Rome III classification of functional gastroduodenal disorders. FD is characterized by the presence of symptoms that are believed to be associated with gastroduodenal lesions, particularly epigastric pain or burning, postprandial fullness, or early satiation, without the evidence of organic disease likely to explain the onset of these symptoms. Generally, multiple factors are considered to be involved in the onset of dyspeptic symptoms in patients with FD. Among these factors, acid is thought to be more important because proton pump inhibitors (PPIs) and histamine 2 (H2)-receptor antagonists have been proposed to be effective therapies for a subset of patients with FD. Although manometric methods, scintigraphic methods, electrogastrography and ultrasonography have been used to evaluate enterokinesis, a practical method for evaluating duodenal hypersensitivity to acid has not been reported. Recently, we attempted to evaluate duodenal hypersensitivity to acid and gastric motility by duodenal acidification using transnasal endoscopy. Using this method, we could simultaneously evaluate both dyspeptic symptoms and gastric motility in healthy volunteers. Furthermore, we evaluated duodenal hypersensitivity to acid in healthy volunteers and in patients with FD, and we reported that duodenal acidification induced dyspeptic symptoms more significantly in patients with FD than in healthy volunteers.

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Section: Methods For Evaluating Duodenal Hypersensitivity To Acid and mentioning

confidence: 99%

Evaluation of Duodenal Hypersensitivity to Acid Using Transnasal Endoscopy

Ishii¹,

Kusunoki²,

Manabe³

et al. 2011

Gastrointestinal Endoscopy

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A Prospective Randomized Comparative Study on the Safety and Tolerability of Transnasal Esophagogastroduodenoscopy

Abstract: Transnasal EGD is safer than transoral EGD as it is associated with fewer adverse effects on cardiopulmonary function and is better tolerated by patients.

Cited by 89 publications

References 7 publications

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

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

Duodenal hypersensitivity to acid in patients with functional dyspepsia-pathogenesis and evaluation

Evaluation of Duodenal Hypersensitivity to Acid Using Transnasal Endoscopy

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