Office-Based Unsedated Small-Caliber Endoscopy Is Equivalent to Conventional Sedated Endoscopy in Screening and Surveillance for Barrett's Esophagus: A Randomized and Blinded Comparison

Abstract

Office-based unsedated small-caliber endoscopy is technically feasible, well tolerated, and accurate in screening for Barrett's esophagus, despite yielding a smaller biopsy specimen. This approach bears the potential to eliminate the infrastructure and cost required for intravenous sedation in this application.

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

“…Although in our study the sensitivity was lower (67%), the specificity was 95% for the diagnosis of BE. In another study, Jobe et al [12] found that, in a cohort of 274 eligible adults scheduled for endoscopic screening for gastroesophageal reflux symptoms or surveillance of BE in a tertiary care center, the prevalence of BE was 26% using conventional endoscopy and 30% using unsedated small-caliber endoscopy (P = 0.503). In this study, the level of agreement between the two approaches was "moderate" (κ = 0.591).…”

“…Thus, several endoscopy techniques have recently been developed as alternatives and less invasive diagnostic tools for evaluating GERD and esophageal varices [12][13][14][15][16]20] . Here, in this study we have shown that unsedated esophagoscopy using a novel disposable transnasal esophagoscope (E.G.…”

“…Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] . Unsedated small-caliber transnasal esophagoscopy offers the possibility of efficient and accurate endoscopic assessment of the esophagus, with less cost and fewer risks compared with sedated upper endoscopy, and can be used as a method to screen for esophageal disease in a primary care population [11][12][13][14][15] . Recently, Chung et al [16] , in a case series study, reported the use of a novel disposable transnasal esophagoscope, the E.G.…”

“…Over the last years, several noninvasive or minimally invasive methods have been proposed as alternatives to conventional EGD for the diagnosis of esophageal diseases, such as esophageal capsule endoscopy (ECE) and ultra-thin small caliber esophagoscopes [7][8][9][10][11][12] . Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] .…”

The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia

“…[15][16][17] The major advantage of TNO is that it can be performed without the need for intravenous sedation or general anaesthesia, which is required for oesophagogastroduodenoscopy or rigid endoscopy respectively. This has profound implications as both sedation and anaesthesia carry significant risks; it is estimated that 0.6% of patients receiving sedation develop a cardiopulmonary event.…”