Reliability and safety of transnasal compared to conventional endoscopy for detecting oesophageal varices in cirrhotic patients

Filho, Elio C. Castro; Perazzo, Hugo; Guimarães, Renata Rangel; Machado, Lílian; Fernandes, Flávia; Perez, Renata M.

doi:10.1111/liv.13692

Cited by 9 publications

(14 citation statements)

References 30 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A further five studies which reported on diagnostic findings during ultra‐thin endoscopy were excluded due to the lack of comparison to a reference standard. Ten studies remained and were considered for data analysis (Figure ) . No further studies were identified through manually hand‐searching references of electronically retrieved articles (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies included only people with suspected, but unknown presence of oesophageal varices (screening cohort) . In the remaining studies, people with an antecedent diagnosis of oesophageal varices were also enrolled (surveillance cohort) . Ultra‐thin endoscopes, with diameters ranging from 3.1 to 5.3 mm were used in all studies, but the make and model differed from study to study.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies conducted UTG without sedation, whereas two studies used conscious sedation in at least some of their participants . Five studies used a transnasal approach for UTG . four studies used a per‐oral approach and one study used either transnasal or oral approach …”

Section: Resultsmentioning

confidence: 99%

“…All 10 studies assessed the accuracy of UTG for the diagnosis of oesophageal varices of any size. Six studies further assessed the accuracy of UTG for the diagnosis of medium‐large oesophageal varices and three studies assessed the accuracy of UTG for the diagnosis of all high‐risk oesophageal varices Three studies assessed the accuracy of UTG for the diagnosis of gastric varices . The characteristics of the 10 studies are outlined in Table .…”

Section: Resultsmentioning

confidence: 99%

“…No studies reported an unacceptable delay between performance of UTG and CG, occurring on the same day in nine studies and within a 2‐week interval in the final study. Only five studies provided inter‐observer agreement in index test interpretation …”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Systematic review with meta‐analysis: ultra‐thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis

Wickremeratne

Turner

2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Background:Haemorrhage from ruptured oesophageal varices is a common cause of death in people with cirrhosis. Guidelines recommend screening for varices at time of cirrhosis diagnosis and throughout the course of the disease. Conventional gastroscopy is the criterion standard for variceal screening; however, is invasive, costly, and carries risks related to use of sedation. Ultra-thin gastroscopy (using endoscopes with a shaft diameter ≤6 mm) has been proposed as an alternative method of variceal screening that mitigates these risks. Aim:To determine the diagnostic accuracy of ultra-thin gastroscopy compared to conventional gastroscopy for the diagnosis of varices in people with cirrhosis.Methods: MEDLINE, EMBASE and Cochrane library databases were searched for studies that evaluated the accuracy of ultra-thin gastroscopy compared to conventional gastroscopy in the diagnosis of oesophageal varices.Results: Ten studies, 7 in known cirrhosis, with 752 participants were included in this systematic review. The overall prevalence of oesophageal varices was 42%. On bivariate modelling, pooled estimates of sensitivity and specificity were 98% (95% CI 93%-99%) and 96% (95% CI 91%-99%) respectively. The positive and negative likelihood ratios were 28 (95% CI 10.7-73.2) and 0.02 (95% CI 0.01-0.72) respectively.Kappa coefficient for inter-observer agreement for any varices ranged from 0.45 to 0.90. No serious adverse events related to ultra-thin gastroscopy were reported.Conclusions: Ultra-thin gastroscopy is accurate in the diagnosis of oesophageal varices, safe and well tolerated. It is a valid alternative to conventional gastroscopy for the screening and surveillance of varices in people with cirrhosis. | 1465WICKREMERATNE ET Al.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review with meta‐analysis: ultra‐thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis

Wickremeratne

Turner

2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy

et al. 2022

View full text Add to dashboard Cite

Diagnostic unsedated transnasal endoscopy (uTNE) has been proven to be a safe and well-tolerated procedure. Although its utilization in the United Kingdom (UK) is increasing, it is currently available in only a few centers. Through consideration of recent studies, we aimed to perform an updated review of the technological advances in uTNE, consider their impact on diagnostic accuracy, and to determine the role of uTNE in the COVID-19 era. Current literature has shown that the diagnostic accuracy of uTNE for identification of esophageal pathology is equivalent to conventional esophagogastroduodenoscopy (cEGD). Concerns regarding suction and biopsy size have been addressed by the introduction of TNE scopes with working channels of 2.4 mm. Advances in imaging have improved detection of early gastric cancers. The procedure is associated with less cardiac stress and reduced aerosol production; when combined with no need for sedation and improved rates of patient turnover, uTNE is an efficient and safe alternative to cEGD in the COVID-19 era. We conclude that advances in technology have improved the diagnostic accuracy of uTNE to the point where it could be considered the first line diagnostic endoscopic investigation in the majority of patients. It could also play a central role in the recovery of diagnostic endoscopic services during the COVID-19 pandemic.

show abstract

Portal Hypertension

Bass¹,

Alonso²

2021

Pediatric Gastrointestinal and Liver Disease

View full text Add to dashboard Cite

Reliability and safety of transnasal compared to conventional endoscopy for detecting oesophageal varices in cirrhotic patients

Abstract: Unsedated transnasal endoscopy was safe and had an excellent accuracy and high interobserver agreement for detecting oesophageal varices and for identifying high-risk varices in cirrhotic patients.

Cited by 9 publications

References 30 publications

Systematic review with meta‐analysis: ultra‐thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis

Systematic review with meta‐analysis: ultra‐thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis

Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy

Portal Hypertension

Contact Info

Product

Resources

About