Published online Apr 16, 2014. doi: 10.4253/wjge.v6.i4.128
Revised: January 17, 2014
Accepted: March 3, 2014
Published online: April 16, 2014
AIM: To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy.
METHODS: We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis.
RESULTS: A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G. Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett’s esophagus, and 0.909 for esophageal varices.
CONCLUSION: Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy.
Core tip: Although esophagogastroduodenoscopy (EGD) is considered the gold standard technique for evaluation of mucosal esophageal diseases, the cost and invasiveness of this diagnostic tool limits its utilization in some patients. Thus, in recent years several endoscopy techniques have been developed as alternatives and less invasive diagnostic tools for evaluating gastroesophageal reflux disease and esophageal varices. Here, in this study we have shown that unsedated esophagoscopy using a novel disposable transnasal esophagoscope (E.G. Scan™) is a safe, well-tolerated, effective and accurate screening tool for esophageal diseases, specifically for esophageal varices.