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Prospective randomized trial of transnasal versus peroral endoscopy using an ultrathin videoendoscope in unsedated patients
Author(s) -
Murata Atsuhiko,
Akahoshi Kazuya,
Sumida Yorinobu,
Yamamoto Hidehiko,
Nakamura Kazuhiko,
Nawata Hajime
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04730.x
Subject(s) - medicine , randomized controlled trial , endoscopy , upper endoscopy , surgery
Aim: The aim of this study was to compare the acceptance and tolerance of transnasal and peroral esophagogastroduodenoscopy (EGD) using an ultrathin videoendoscope in unsedated patients. Methods: A total of 124 patients referred for diagnostic endoscopy were assigned randomly to have an unsedated transnasal EGD ( n = 64) or peroral EGD ( n = 60) with local anesthesia. An ultrathin videoendoscope with a diameter of 5.9 mm was used in this study. A questionnaire for tolerance was completed by the patient (a validated 0–10 scale where ‘0’ represents no discomfort/well tolerated and ‘10’ represents severe discomfort/poorly tolerated). Results: Of the 64 transnasal EGD patients, 60 patients (94%) had a complete examination. Four transnasal EGD examinations failed for anatomical reasons; all four patients were successfully examined when switched to the peroral EGD. All 60 peroral EGD patients had a complete examination. Between the transnasal and peroral groups, there was a statistically significant difference in scores for discomfort during local anesthesia (1.5 ± 0.2 vs 2.6 ± 0.3, P = 0.003), discomfort during insertion (2.3 ± 0.3 vs 4.3 ± 0.3, P = 0.001), and overall tolerance during procedure (1.6 ± 0.2 vs 3.8 ± 0.2, P = 0.001). In all, 95% of transnasal EGD patients and 75% of peroral EGD patients ( P = 0.002) were willing to undergo the same procedure in the future. Four patients in the transnasal EGD group experienced mild epistaxis. Conclusion: For unsedated endoscopy using an ultrathin videoendoscope, transnasal EGD is well tolerated and considerably reduces patient discomfort compared with peroral EGD.