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

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• 作者：Anne F. Peery ; MD ; MSCR¹ ; Toshitaka Hoppo ; MD² ; Katherine S. Garman ; MD³ ; ⁴ ; Evan S. Dellon ; MD ; MPH¹ ; Norma Daugherty ; BS¹ ; Susan Bream ; BS¹ ; Alejandro F. Sanz ; MD² ; Jon Davison ; MD² ; Melissa Spacek ; BS¹ ; Diane Connors ; BS² ; Ashley L. Faulx ; MD⁵ ; Amitabh Chak ; MD⁵ ; James D. Luketich ; MD² ; Nicholas J. Shaheen ; MD ; MPH¹ ; Blair A. Jobe ; MD² ; ; Barrett's Esophagus Risk Consortium
• 关键词：BMI ; body mass index ; SCJ ; squamocolumnar junction
• 刊名：Gastrointestinal Endoscopy
• 出版年：2012
• 期刊代码：130_00165107
• 类别：med
• 出版时间：May, 2012
• 卷：75
• 期：5
• 页码：945-953.e2
• 文件大小：768 K

摘要

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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 [卤 standard deviation] age 55.8 卤 9.5 years; 43%male) enrolled in the study, and 422 (99%) completed the examination. Mean (卤 standard deviation) examination time was 3.7 卤 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.