Unsedated esophagoscopy with small-diameter endoscopes is generally well tolerated.
However, this has limited sensitivity for the diagnosis of esophageal mucosal disease.
In this study, researchers from Cleveland, Ohio, evaluated the sensitivity of esophagoscopy performed with new 4-mm diameter prototype battery-powered and video endoscopes.
The research team assessed patient tolerance for an unsedated examination with the 4-mm endoscopes. They additionally assessed the performance characteristics of the battery-powered and video 4-mm endoscopes were compared.
The team recruited patients referred for EGD to undergo an additional examination with a 4-mm endoscope.
|Sensitivity, specificity, and accuracy for identification of Barrett's esophagus was 100%.|
A prototype 60-cm long, 4-mm diameter battery-powered fiberoptic esophagoscope was used in 24 patients. A prototype 60-cm long, 4-mm diameter video esophagoscope was used in 27 patients.
Examiners who were unaware of patient history and procedure indications recorded esophageal findings, ease of intubation, optical quality, and time for examination of the esophagus. They also then recorded esophageal findings after the standard EGD.
The research team found that the sensitivity, specificity, and accuracy for identification of Barrett's esophagus was 100%. The overall sensitivity, accuracy, and specificity for detecting esophageal lesions were 91%, 98%, and 99%, respectively.
They also found that patient tolerance of unsedated esophagoscopy with the 4-mm instruments was significantly better than in a group of patients examined with a 3-mm endoscope.
The team rated the optical quality of video endoscope as superior to that of battery-powered endoscope. In addition, esophageal examination was performed significantly quicker with the video versus the battery-powered endoscope.
Dr Andrew Catanzaro’s team concluded, “Unsedated esophagoscopy with 4-mm diameter endoscopes may be an alternative to EGD for screening for Barrett's esophagus”.
“Given the current state of endoscopic technology, a minimum diameter of 4 mm is required for satisfactory esophageal imaging.”