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Clinical Trial
. 2012 May;75(5):945-953.e2.
doi: 10.1016/j.gie.2012.01.021. Epub 2012 Mar 16.

Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video)

Anne F Peery  1 , Toshitaka Hoppo, Katherine S Garman, Evan S Dellon, Norma Daugherty, Susan Bream, Alejandro F Sanz, Jon Davison, Melissa Spacek, Diane Connors, Ashley L Faulx, Amitabh Chak, James D Luketich, Nicholas J Shaheen, Blair A Jobe; Barrett's Esophagus Risk Consortium
Affiliations
Clinical Trial

Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video)

Anne F Peery et al. Gastrointest Endosc. 2012 May.

Abstract

Background: Endoscopic screening for esophageal neoplasia can identify patients eligible for early intervention for precancerous lesions. Unsedated transnasal esophagoscopy may provide an efficient and accurate endoscopic assessment with fewer risks and less cost, compared with conventional upper endoscopy.

Objective: To assess the feasibility, safety, acceptability, and yield of unsedated transnasal esophagoscopy in a primary care population.

Design: Multicenter, prospective, cross-sectional study.

Setting: Two outpatient tertiary-care centers.

Patients: This study involved a general medical clinic population aged between 40 and 85 years.

Intervention: Unsedated, office-based transnasal esophagoscopy.

Main outcome measurements: Procedure yield; completeness of examination; procedure length; adverse events and complications; choking, gagging, pain, or anxiety during the examination; and overall tolerability.

Results: A total of 426 participants (mean [± standard deviation] age 55.8 ± 9.5 years; 43% male) enrolled in the study, and 422 (99%) completed the examination. Mean (± standard deviation) examination time was 3.7 ± 1.8 minutes. There were no serious adverse events, and 12 participants (2.8%) reported minor complications. Participants reported minimal choking, gagging, pain, or anxiety. The examination was well-tolerated by most participants. Overall, 38% of participants had an esophageal finding that changed management (34% erosive esophagitis, 4% Barrett's esophagus).

Limitations: Nonrandomized study, tertiary-care centers only, self-selected population with a large proportion reporting esophageal symptoms.

Conclusion: Unsedated transnasal esophagoscopy is a feasible, safe, and well-tolerated method to screen for esophageal disease in a primary care population. Endoscopic findings are common in this patient population.

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Figures

Figure 1
Figure 1
One-wheel TNE-5000 video endoscope encased in 4.7 mm diameter disposable sheath (Vision Sciences, Orangeburg, NY
Figure 2
Figure 2
10-question assessment to measure procedure acceptability
Figure 3
Figure 3
Reported esophageal symptoms and percentage found to have erosive esophagitis on transnasal examination
Figure 4
Figure 4
An image captured from a participant with intestinal metaplasia
See this image and copyright information in PMC

Comment in

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