Office‐Based Esophagoscopy: A Preliminary Report

Aviv, Jonathan E.; Takoudes, Thomas G.; Ma, Guoguang; Close, Lanny Garth

doi:10.1067/mhn.2001.117873

Cited by 72 publications

(92 citation statements)

References 12 publications

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“…Reviewing previous studies on the application of unsedated transnasal esophagoscopy or EGD in otolaryngology; however, most investigations have focused on benign diseases, such as globus pharyngius, reflux esophagitis, esophageal foreign body, or placement of the tracheoesophageal puncture. [5][6][7]9,10 Only a limited number of studies have limited experience about the role of unsedated transnasal esophagoscopy or EGD in head and neck oncology. 6,9,11,12 In this article, we provide a detailed report on the efficacy and safety of unsedated transnasal EGD in the diagnosis of hypopharyngeal cancer and screening of simultaneous esophageal lesions.…”

mentioning

confidence: 99%

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

et al. 2008

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confidence: 99%

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

et al. 2008

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“…9,12 Tolerability of intubating the esophagus and visualizing the mucosa clearly is excellent with UUE (95% to 100%). 5,13,14 Additionally, the feasibility of UUE has been reported by gastroenterologists and otolaryngologists. 7,13 One study reported the feasibility and accuracy of UUE for esophageal screening by nurse practioners.…”

Section: Esophagoscopy In Primary Carementioning

confidence: 95%

“…logic fi ndings in patients with dysphagia 5 and head and neck cancers, 6 to identify esophageal varices, 7 and to screen for Barrett' s esophagus. [8][9][10][11][12] UUE has a sensitivity of 75% to 91% and a specifi city 98% to 99% for esophageal lesions, eg, hiatal hernia and esophagitis.…”

Section: Esophagoscopy In Primary Carementioning

confidence: 99%

Office-Based Unsedated Ultrathin Esophagoscopy in a Primary Care Setting

Wilkins

Gillies

2005

The Annals of Family Medicine

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PURPOSE Gastroesophageal refl ux disease is common and with time may be complicated by Barrett's esophagus and esophageal adenocarcinoma. Upper gastrointestinal endoscopy, including esophagoscopy, is the procedure of choice to diagnose Barrett's esophagus and other esophageal disease. The use of unsedated ultrathin esophagoscopy (UUE) has been reported by gastroenterologists in specialized endoscopy units and otolaryngologists in outpatient otolaryngology offi ces, but UUE has not been previously described in a primary care setting. This study examines the feasibility of offi ce-based UUE in primary care. METHODSThis study is a retrospective chart review in a university-based family medicine clinic in the southeastern United States. Charts were reviewed of 56 adult outpatients who were referred for further evaluation of refl ux symptoms that persisted after at least 4 weeks of therapy with histamine 2 receptor agonists or proton pump inhibitors and who elected to undergo UUE in the primary care setting. Patient demographics, procedure indications and fi ndings, changes in clinical management, and procedure times were recorded. RESULTSOne hundred percent of patients asked to participate in UUE were willing to undergo the procedure (mean age 48.3 ± 1.6 y, 57.1% women); 95% of the patients tolerated UUE. Barrett's esophagus was diagnosed in 5.7% (n = 3) of the patients. Mean procedure time was 5.5 ± 1.7 min. No complications were reported in this series.CONCLUSIONS Initial data suggest that UUE is feasible in primary care, with the majority of patients tolerating the procedure. UUE may be an effi cient method of examining the distal esophagus. INTRODUCTIONG astroesophageal refl ux disease (GERD) is a chronic disease encountered in primary care and requires lifelong therapy in as many as 50% of patients. 1 Barrett' s esophagus is a complication of chronic GERD found in approximately 10% of patients undergoing upper gastrointestinal endoscopies for GERD.2 Chronic GERD and Barrett' s esophagus are risk factors for esophageal adenocarcinoma, which has one of the lowest cancer cure rates (10%).3 Screening strategies for esophageal cancer have therefore focused on identifying Barrett' s esophagus through upper gastrointestinal endoscopies in patients with chronic GERD symptoms. Surveillance endoscopy in patients with Barrett' s esophagus has been associated with earlier detection of esophageal cancer and improved survival. 4 Recent advances in technology have led to the development of an ultrathin video esophagoscope that can be introduced either orally or nasally in an unsedated patient to visualize the esophagus and gastroesophageal junction. A thinner and more fl exible scope may decrease patient discomfort and enhance overall tolerability of an unsedated examination. Unsedated ultrathin esophagoscopy (UUE) has been used to defi ne patho- [8][9][10][11][12] UUE has a sensitivity of 75% to 91% and a specifi city 98% to 99% for esophageal lesions, eg, hiatal hernia and esophagitis. 9,12 For diagnosis of Barret...

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“…The introduction of office-based transnasal esophagoscopy (TNE) and its subsequent embrace by otolaryngologists has made screening endoscopy available to a group of patients potentially at risk for developing Barrett's esophagus and esophageal adenocarcinoma. 8,9 The substantial direct and indirect cost savings have also served to increase the appeal of screening patients with LPR by means of TNE. 10 A recent TNE study reported a discrepancy between the rate of endoscopic diagnosis of Barrett's esophagus and the rate of pathology-confirmed diagnosis of Barrett's esophagus.…”

Section: Introductionmentioning

confidence: 99%