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:
CreatorsEmailORCIDORCID Put Code
Knuth, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kunze, D. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benz, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bulian, D. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heiss, M. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lefering, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saad, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saers, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krakamp, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
OUTPATIENT GASTROENTEROLOGY PRACTICE; UNSEDATED ULTRATHIN EGD; ENDOSCOPY; SEDATION; SAFETY; ACCEPTABILITY; ESOPHAGOSCOPY; FEASIBILITY; DIAMETERMultiple languages
Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47080

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