Universität zu Köln

Knuth, J., Kunze, D. E., Benz, C., Bulian, D. R., Heiss, M. M., Lefering, R., Saad, S., Saers, T. and Krakamp, B. (2013). Is the Transnasal Access for Esophagogastroduodenoscopy in Routine Use Equal to the Transoral Route? A Prospective, Randomized Trial. Z. Gastroent., 51 (12). S. 1369 - 1377. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-7803

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Abstract

Background and Study Aims: Routine esophagogastroduodenoscopy (EGD) is increasingly performed without sedation. Transoral (TO) and transnasal (TN) EGD offer different patient comfort and complications. Patients and Methods: For a controlled, randomized, clinical trial comparing TN-EGD with TO-EGD without sedation, patients were assigned to TN-EGD using a thin endoscope (group 1, 93 patients), or TO-EGD using a standard endoscope (group 2, 90 patients). Physician-rated procedural time and complications as well as patient-rated side effects and preferences were compared. In group 3, patients (118) who had previously undergone TO-EGD, now underwent TN-EGD. Results: Between group 1 and 2 there was no significant difference for procedural time. Nausea (p=0.047) and epistaxis (p<0.001) were significantly more frequent for TN-EGD. Conversion rate from TN- to TO-EGD was low with 4.3%. For TN-EGD, patients' tolerance was better (p<0.001), gagging was less (p<0.001). In case of a future EGD, patients who know both procedures (group 3), strongly vote for TN-EGD (80%). All groups vote against sedation for future procedures (90%/90%/89%). Conclusions: Epistaxis can be relevant after TN-EGD, but can mostly be managed conservatively. TN-EGD is superior to TO-EGD regarding subjective and objective gagging as well as procedural tolerance. Patients who experienced both access routes, prefer TN-EGD. TN-EGD without sedation should be aspired for patient comfort and is recommended for routine use.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Knuth, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kunze, D. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Benz, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bulian, D. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, M. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lefering, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saad, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saers, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krakamp, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-470800
DOI:	10.1055/s-0033-1335749
Journal or Publication Title:	Z. Gastroent.
Volume:	51
Number:	12
Page Range:	S. 1369 - 1377
Date:	2013
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-7803
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OUTPATIENT GASTROENTEROLOGY PRACTICE; UNSEDATED ULTRATHIN EGD; ENDOSCOPY; SEDATION; SAFETY; ACCEPTABILITY; ESOPHAGOSCOPY; FEASIBILITY; DIAMETER Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47080