Prospective study comparing conventional and transnasal esophagogastroduodenoscopy for routine diagnosis

摘要

INTRODUCTION: Transnasal gastroscopy (TNG) is the result of ongoing improvements in endoscopic device development. These ultrathin endoscopes are planned to improve patient satisfaction with the endoscopic procedure. AIM: The aim of the current study was to prospectively evaluate the performance and patient acceptance of transnasal gastroscopy. PATIENTS AND METHODS: Sixty-three consecutive patients (40 males, 23 females, mean age 58.5 years) referred for routine upper gastrointestinal endoscopy to our tertiary care referral centre were assigned to one of three groups: first time transnasal gastroscopy (group 1, TNG), first time transoral gastroscopy (group 2, TOG) and transnasal gastroscopy after a previous unsedated transoral gastroscopy (group 3). All examinations were performed without intravenous sedation. Patients answered a standardised questionnaire immediately following the examination. RESULTS: The three groups of patients did not differ in age, gender or reason for gastroscopy. Investigationsperformed using transnasal technique were significantly shorter (TNG 8.9 min and 9.2 min vs. TOG 11.9 min, p = 0.011 and p = 0.026, respectively) than those performed in transoral technique. Nosebleeding, albeit not clinically significant, and the urge to wretch were significantly more common in the transnasal technique group (p > 0.001). Patient acceptance tended to score higher in the transnasal technique groups, however not statistically higher. A greater number of patients from group 3 (TNG after previous TOG) would prefer a repeat exam via the transnasal route. CONCLUSIONS: Transnasal gastroscopy represents a possible alternative to the conventional transoral technique. TNG entails less subjective patient discomfort, and patients experienced in both techniques prefer the transnasal route. Shorter examination times and lack of intravenous sedation result in several benefits: no sedation-related complications, shorter post-procedure observation times, and subsequently shorter time off work for patients.