A widely available, cost-effective technique is needed to screen a broad population for esophageal cancer.
A solution may be performing unsedated esophagoscopy with an entirely self-contained, small-caliber endoscope.
In this study, researchers compared the feasibility, patient tolerance, and diagnostic accuracy of esophagoscopy performed with a prototype, superthin, battery-powered esophagoscope (BPE) with standard video esophagogastroduodenoscopy (SVE).
Initially, 10 healthy volunteers underwent peroral and transnasal esophagoscopy with BPE to evaluate the technical feasibility of the examination.
The endoscopists reported adequate visualization of the esophagus in all 10 volunteers.
For parts 2 and 3 of the study, 181 patients underwent BPE before SVE.
In part 2, both procedures were performed with conscious sedation.
However, in part 3 the team performed BPE using only topical anesthesia.
Two endoscopists assessed the technical performance of the endoscope and patient tolerance and recorded the esophageal findings independently.
The research team found that the sensitivity for detecting columnar lined esophagus was 94% in part 2 and 95% in part 3.
The sensitivity for all esophageal findings was 87% and 86% in parts 2 and 3, respectively.
The team determined that technical performance was significantly poorer for BPE, compared to the SVE.
However, patient tolerance was similar for both procedures.
Furthermore, 95% of patients undergoing unsedated BPE were willing to have the procedure repeated.
Dr Mahesh Mokhashi's concluded, "Unsedated esophagoscopy with a 3.1-mm, battery-powered, stand-alone esophagoscope is feasible, well tolerated, and accurate in detecting esophageal pathologies".
"It might be an efficient and cost-effective screening tool for the detection of columnar lined esophagus".