Is the transnasal access for esophagogastroduodenoscopy in routine use equal to the transoral route? A prospective, randomized trial.
Z Gastroenterol
; 51(12): 1369-76, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-24146101
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 ANDMETHODS:
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 (pâ=â0.047) and epistaxis (pâ<â0.001) were significantly more frequent for TN-EGD. Conversion rate from TN- to TO-EGD was low with 4.3â%. For TN-EGD, patients' tolerance was better (pâ<â0.001), gagging was less (pâ<â0.001). In case of a future EGD, patients who know both procedures (group 3), strongly vote for TN-EGD (80â%). All groups vote against sedation for future procedures (90â%/90â%/89â%).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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor
/
Vómitos
/
Epistaxis
/
Endoscopía del Sistema Digestivo
/
Atragantamiento
/
Náusea
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Z Gastroenterol
Año:
2013
Tipo del documento:
Article
Pais de publicación:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY