Unsedated esophagogastroduodenoscopy has diagnostic accuracy

Unsedated esophagogastroduodenoscopy accurately recognizes endoscopic markers in H pylori-uninfected patients, finds the latest Gastrointestinal Endoscopy.

Drs Akira Horiuchi and Yoshiko Nakayama from Japan assessed the acceptability and the diagnostic accuracy of unsedated ultrathin esophagogastroduodenoscopy.

The researchers used a newly developed 5.2 mm-diameter videoscope.

The team compared it with sedated small-caliber unsedated ultrathin esophagogastroduodenoscopy by using a 6.5 mm-diameter videoscope.

The researchers also evaluated sedated conventional esophagogastroduodenoscopy by using a 9 mm-diameter videoscope.

The team identified a total of 120 patients who undergo esophagogastroduodenoscopy every year as part of gastric cancer surveillance.

The team assessed 80 patients who had undergone sedated small-caliber esophagogastroduodenoscopy approximately 1 year earlier.

Unsedated esophagogastroduodenoscopy had 93% accuracy

Gastrointestinal Endoscopy

The researchers randomized 40 patients to receive unsedated ultrathin or 40 to sedated small-caliber esophagogastroduodenoscopy.

Endoscopist satisfaction and patient comfort were assessed by using a 10-cm visual analog scale.

Patient comfort level was compared with that of the previous sedated small caliber esophagogastroduodenoscopy.

The 40 patients who had undergone sedated small calibre esophagogastroduodenoscopy within the previous 2 years underwent unsedated ultrathin esophagogastroduodenoscopy.

The researchers compared the optical quality and esophagogastroduodenoscopy findings between the methods.

The ability to identify the rearrangement of collecting venues pattern for no Helicobacter pylori was evaluated in 80 patients undergoing unsedated ultrathin esophagogastroduodenoscopy.

The team compared the results with those of a ¹³C-urea breath test or H pylori stool antigen test.

The patient comfort level of unsedated ultrathin esophagogastroduodenoscopy was better than that of sedated small-caliber esophagogastroduodenoscopy.

The optical quality of the endoscopic images and the esophagogastroduodenoscopy findings were similar between the methods.

The sensitivity, and specificity of unsedated ultrathin esophagogastroduodenoscopy in recognizing H pylori-uninfected patients was 90%, and 100%, respectively.

The accuracy of the rearrangement of collecting venues pattern in unsedated esophagogastroduodenoscopy in recognizing H pylori-uninfected patients was 93%.

The researchers reported that the interobserver agreement for rearrangement of collecting venues was good.

Dr Horiuchi and colleague conclude, “The use of a 5.2-mm-diameter videoscope is expected to enhance the patient acceptance of unsedated esophagogastroduodenoscopy.”