Office-based sedation-free transnasal esophagogastroduodenoscopy with biopsies using single-use gastroscopes: A pediatric single-center experience.

Autor: Smadi Y; Eosinophilic Esophagitis Center Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA., Thomas J; Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA., Bittar K; Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA., Norton H; Nurse Care Coordinator, Eosinophilic Esophagitis Center Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA., Friedlander JA; EvoEndo, Inc. Centennial Colorado USA., Bornstein J; Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA.
Jazyk: angličtina
Zdroj: JPGN reports [JPGN Rep] 2023 Dec 20; Vol. 5 (1), pp. 29-34. Date of Electronic Publication: 2023 Dec 20 (Print Publication: 2024).
DOI: 10.1002/jpr3.12025
Abstrakt: Introduction: Unsedated transnasal endoscopy (TNE) as transnasal esophagoscopy (TN-Eso) has emerged as a promising alternative to esophagogastroduodenoscopy (EGD) under sedation to assess eosinophilic esophagitis (EoE). We report our center's experience using single-use gastroscopes to perform sedation-free transnasal EGD (TN-EGD) with biopsies in an office-based setting.
Methods: A retrospective review was performed on patients with eosinophilic esophagitis who underwent office-based sedation-free TNE with topical analgesia and virtual reality (VR) procedural dissociation and distraction. A sterile, single-use, ultra-slim 3.5 mm outer diameter, 110 cm long gastroscope with 2 mm working channel (EvoEndo) was used to perform TNE with biopsies/brushings. Data including demographics, procedure success rate, total visit time, biopsy adequacy, procedure time, procedural preference, and complications were collected.
Results: Office-based TNE was completed in 8 patients (six males, age range 11-20 years). The endoscope was advanced by an experienced transoral endoscopist successfully through the nares into stomach (transnasal esophagogastroscopy [TN-EG]) in all subjects (100%) and into the duodenum (TN-EGD) in seven subjects (87.5%). Biopsies were obtained from esophagus in all cases and from the stomach/duodenum in five cases. Histological assessment, esophageal brushing, disaccharidase enzyme analysis, or duodenal aspirate analysis were performed as indicated. EoE reevaluation was the primary indication to perform endoscopy in all patients. Visual and histologic findings were all adequate for assessment. There were no significant adverse events.
Conclusion: Office-based TN-EGD with VR procedural distraction and dissociation using single-use gastroscopes was effective to monitor EoE, gastritis, and duodenitis in a pediatric practice.
Competing Interests: Joel A. Friedlander is Chief Medical Officer and Board Member of EvoEndo®, Inc. He is listed on numerous patents and pending patents related to endoscopic and virtual reality technologies. The remaining authors declare no conflict of interest.
(© 2023 The Authors. JPGN Reports published by Wiley Periodicals LLC on behalf of The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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