Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video).
Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video).
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DOI：
10.1016/j.gie.2012.01.021
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发表时间：
2012-05
影响因子：
7.7
通讯作者：
Barrett's Esophagus Risk Consortium
中科院分区：
文献类型：
--
作者：
Peery AF;Hoppo T;Garman KS;Dellon ES;Daugherty N;Bream S;Sanz AF;Davison J;Spacek M;Connors D;Faulx AL;Chak A;Luketich JD;Shaheen NJ;Jobe BA;Barrett's Esophagus Risk Consortium
食管肿瘤的内窥镜筛查可以识别出适合对癌前病变进行早期干预的患者。与传统的上消化道内窥镜检查相比，无镇静的经鼻食管镜检查可以提供有效且准确的内窥镜评估，风险更少，成本更低。评估初级保健人群中不镇静经鼻食管镜检查的可行性、安全性、可接受性和效果。多中心、前瞻性、横断面研究。两个门诊三级中心。 40 岁至 85 岁之间的普通医疗诊所人群。不镇静、办公室经鼻食管镜检查。 1) 手术合格率，2) 检查的完整性，3) 手术长度，4) 不良事件和并发症，5) 检查期间窒息、作呕、疼痛或焦虑，以及 6) 总体耐受性 426 名参与者（平均年龄 55.8 ± 9.5，43% 男性）参加了该研究，422 名参与者 (99%) 完成了检查。平均检查时间为 3.7 ± 1.8 分钟。没有发生严重不良事件，12 名参与者 (2.8%) 报告了轻微并发症。参与者报告了轻微的窒息、作呕、疼痛或焦虑。大多数参与者对检查的耐受性良好。总体而言，38% 的受试者因食管发现改变了治疗方法（34% 为糜烂性食管炎，4% 为巴雷特食管）。非随机研究；仅限高等教育中心；自我选择的人群，其中很大一部分报告有食管症状。无镇静经鼻食管镜检查是一种可行、安全且耐受性良好的初级保健人群食管疾病筛查方法。内窥镜检查结果在该患者群体中很常见。
Endoscopic screening for esophageal neoplasia can identify patients eligible for early intervention for pre-cancerous lesions. Unsedated transnasal esophagoscopy may provide an efficient and accurate endoscopic assessment with fewer risks and less cost compared to conventional upper endoscopy. To assess the feasibility, safety, acceptability and yield of unsedated transnasal esophagoscopy in a primary care population. Multi-center, prospective, cross-sectional study. Two outpatient tertiary centers. General medical clinic population between the ages of 40 and 85. Unsedated, office-based transnasal esophagoscopy. 1) Procedure yield, 2) Completeness of examination, 3) Procedure length, 4) Adverse events and complications, 5) Choking, gagging, pain or anxiety during the examination, and 6) Overall tolerability Four hundred and twenty-six participants (mean age 55.8 ± 9.5, 43% male) enrolled in the study, and 422 (99%) completed the examination. Mean examination time was 3.7 ± 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 subjects had an esophageal finding that changed management (34% erosive esophagitis, 4% Barrett’s esophagus). Nonrandomized study; tertiary centers only; self-selected population with a large proportion reporting esophageal symptoms. 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.