EGD can be performed transnasally in adults using small-diameter endoscopes.
In this prospective study, researchers from France evaluated the feasibility, and tolerance, of diagnostic transnasal EGD in daily practice.
The research team performed unsedated transnasal EGD in 1100 consecutive patients, in 3 different institutions, using either a 5.9mm or a 5.3mm diameter endoscope.
The EGD operator determined whether each procedure was successful or unsuccessful, the reason for failures, and any side effects.
|91% of patients who had undergone unsedated peroral EGD, preferred transnasal EGD with a small-diameter endoscope.|
The researchers then evaluated the influence of gender, age, endoscope diameter, and type of topical anesthesia on the success or failure of the procedure.
In addition, patients who had previously undergone peroral EGD were questioned as to which procedure they preferred.
The team found that transnasal EGD was feasible in 94% of patients.
They identified causes of failure as unsuccessful transnasal insertion (63%), patient refusal (19%), and nasal pain (18%).
Furthermore, significant predictive factors for procedure failure were female gender, young age (≤35 years), and larger-endoscope diameter.
The researchers found that side effects included epistaxis (2.3%), nasal pain (1.6%), and vaso-vagal reaction (0.3%).
However, the majority (91%) of the patients who had previously undergone unsedated peroral EGD with a standard 9.8-mm diameter endoscope, preferred transnasal EGD with a small-diameter endoscope.
Dr Jérôme Dumortier’s team concluded, “Transnasal EGD is feasible in daily endoscopic practice and is preferred by patients”.
Furthermore, “Side effects are rare”.