Endoscopy 2001; 33(11): 966-968
DOI: 10.1055/s-2001-17928
DDW Reports 2001
© Georg Thieme Verlag Stuttgart · New York

Miscellaneous Topics

T. Rösch
  • Dept. of Internal Medicine II, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Publikationsverlauf

Publikationsdatum:
18. Oktober 2001 (online)

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Transnasal Endoscopy

Thin transnasal endoscopes (diameter 5 - 6 mm) have been on the market for some time, and have been shown to be better tolerated than endoscopy via the oral route (without sedation) - possibly at the loss of image quality, although this is difficult to quantify. In a multicenter study in France involving 500 patients, the transnasal endoscope was compared with the standard gastroscope introduced transorally, and only a local spray was allowed. The rate of failure to intubate was higher with the transnasal route (6.8 % vs. 1.7 %), and visibility was better with the standard endoscope (significant only for the cardia). The transnasal route was better tolerated by patients (willingness to repeat endoscopy 90 % versus 75 %), although 25 % of patients reported pain in the nostrils [1]. A similar endoscope was used in routine practice in 1327 consecutive outpatients, with a mean examination time of 3.1 min (we had thought that Olympic records in gastroscopy were over) and a completion rate of 95 %, with good patient tolerance [2]. Two groups presented the next step - use of a battery-powered ultrathin endoscope (3 mm in diameter), which is intended only for esophageal examination; its accuracy in detecting disease was substantially inferior to that of standard EGD (sensitivities for various disorders 54 - 84 %) [3]. Another study found that patient acceptance of unsedated esophagoscopy, even with this very thin endoscope, was limited - only 50 % of the 48 patients who underwent both ultrathin and conventional endoscopy stated that they would prefer the thin scope in the future [4]. It remains to be seen whether slim endoscopes will be able to establish themselves, by improving both patient acceptance and image quality.

References

T.  Rösch, M.D.

Dept. of Internal Medicine II
Klinikum rechts der Isar
Technical University of Munich

Ismaningerstrasse 22
81675 München
Germany


Fax: + 49-89-4140-4872

eMail: thomas.roesch@lrz.tum.de