Comparison of Rigid and Flexible Esophagoscopy in the Diagnosis of Esophageal Disease: Diagnostic Accuracy, Complications, and Cost

Glaws, W.Reid; Etzkorn, K. Peter; Wenig, Barry L.; Zulfiqar, Hassan; Wiley, Tisha R. A.; Watkins, J

doi:10.1177/000348949610500403

Cited by 32 publications

(19 citation statements)

References 22 publications

(3 reference statements)

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“…Rigid oesophagoscopy is no longer recommended as flexible endoscopy is safer and more cost effective. 65 The specificity of barium studies versus primary endoscopy is similar 49 but endoscopy allows for biopsy and cytology, which are essential for confirming the diagnosis. 66 There are no randomised trials to show a benefit of endoscopy over barium studies but it has been suggested that increasing the ease of investigating late onset dyspepsia could increase the proportion of early gastric cancers to 26%.…”

Section: Diagnosismentioning

confidence: 99%

Guidelines for the management of oesophageal and gastric cancer

Allum

Griffin

Watson

et al. 2002

Gut

291

183

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Section: Diagnosismentioning

confidence: 99%

Guidelines for the management of oesophageal and gastric cancer

Allum

Griffin

Watson

et al. 2002

Gut

291

183

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“…The morbidity and mortality is low. 1 In this day and age, it may still be the most sensitive way of detecting superficial mucosal lesions. 2 There is, however, increasing evidence that the incidence of simultaneous malignancies may be in the low single figures.…”

Section: Discussionmentioning

confidence: 99%

“…1,9 In the modern era of medicine, cost-effectiveness is an increasing issue with clinicians often having to justify interventions on this basis. [10][11][12] It certainly seems within the UK that a more selective approach to EUAP is gradually developing; although this may, in part, be due to financial restrictions, there is certainly a medical evidence-base to support this move.…”

Section: Discussionmentioning

confidence: 99%

The Use of Examination Under Anaesthesia and Panendoscopy in Patients Presenting with Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Kerawala

Bisase

Lee

2009

annals

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INTRODUCTION Although examination under anaesthesia and panendoscopy (EUAP) has traditionally been used in the assessment of patients presenting with oral cavity and oropharyngeal squamous cell carcinoma (SCC), the era of modern medicine with its advanced imaging techniques has meant that the indications for this technique have potentially reduced. SUBJECTS AND METHODS In an attempt to quantify the current use of EUAP in the UK, a structured telephone questionnaire was undertaken of 50 maxillofacial units. Information was gathered regarding whether the technique was adopted on a routine or selective basis. Likewise perceived disadvantages were sought. RESULTS Twenty-two units (44%) carried out EUAP on all patients presenting with oral cavity and oropharyngeal SCC. Of the remaining 28 units, all employed EUAP on a selective basis, the most commonly for the assessment of the primary tumour. The most common perceived disadvantage of carrying out EUAP routinely was its potential to increase the waiting time to definitive treatment. CONCLUSIONS These results suggest a gradual move towards the selective use of EUAP in patients presenting with oral cavity and oropharyngeal SCC. KERAWALA BISASE LEE EUAP IN ORAL CAVITY AND OROPHARYNGEAL SQUAMOUS CELL CARCINOMA PATIENTSAnn R Coll Surg Engl 2009; 91: 609-612 610 on a selective basis. For the purposes of the study 'panendoscopy' was defined as the endoscopy of the nasal cavity, nasopharynx, oropharynx, larynx and upper oesophagus, with or without bronchoscopy. The indications for EUAP were obtained in terms of index tumour assessment, detection of simultaneous disease in the asymptomatic individual and its use as a 'test anaesthetic'. In units with a selective approach, further information regarding that process was elicited, e.g. did a patient's exposure to risk factors influence its use? Finally, the perceived advantages of EUAP were obtained where relevant. ResultsRepresentatives from 50 maxillofacial units were questioned. Of these, 22 (44%) employed EUAP on all patients. Of the remaining 28 units, the most common indication for EUAP was the assessment of the index tumour (Fig. 1). Around one in four units still felt that the use of EUAP as a 'test anaesthetic' was justified.For those units adopting a selective approach, the most commonly perceived disadvantage of routine EUAP was a potential increase in waiting time to definitive treatment (Fig. 2). One-third of units also expressed concern regarding the cost implications of a second anaesthetic. DiscussionEUAP was introduced in the management of head and neck malignancy in the late 1970s and is still used in many units throughout the world on a routine basis. It requires little in the way of equipment and remains less expensive than some of the alternative modes of staging patients such as computed tomography (CT), magnetic resonance imaging (MRI) and positron imaging tomography. The morbidity and mortality is low.1 In this day and age, it may still be the most sensitive way of detecting superficial mucosal ...

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“…Es gibt zahlreiche Studien,die die Indikationsspektren und Komplikationsraten der starren und flexiblen Endoskopie der Luft-und oberen Speisewege verglichen haben und durchaus zu unterschiedlichen Bewertungen gekommen sind [4,5,7,8,13].Beide Verfahren,sowohl starre als auch flexible Endoskopie,haben bevorzugte Indikationen und stehen sich teilweise gleichberechtigt gegenüber.…”

Section: Indikationsspektrenunclassified

Diagnostische und interventionelle HNO-Endoskopie

Stasche

Bärmann

2004

HNO

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Both flexible and rigid endoscopy have become very common in ENT in the last decade. This has led to an increase in the diagnostic and therapeutic spectrum, and, in particular, quality control. Because the purchasing price of optical systems, as well as their maintenance, can be quite expensive, the expected spectrum of applications should be taken into account in choosing endoscopic equipment. This review provides aid in choosing the right system without defining legally binding parameters.

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Comparison of Rigid and Flexible Esophagoscopy in the Diagnosis of Esophageal Disease: Diagnostic Accuracy, Complications, and Cost

Cited by 32 publications

References 22 publications

Guidelines for the management of oesophageal and gastric cancer

Guidelines for the management of oesophageal and gastric cancer

The Use of Examination Under Anaesthesia and Panendoscopy in Patients Presenting with Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Diagnostische und interventionelle HNO-Endoskopie

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