Eosinophilic Esophagitis: Search for Non-Invasive Techniques for Long-Term Monitoring
| Autor: | Jeffrey A. Alexander, Abhishek Watts, Sandeep K. Gupta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Natural Orifice Endoscopic Surgery medicine.medical_specialty Adolescent Biopsy Gastroenterology Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine medicine Eosinophilia Humans Radiology Nuclear Medicine and imaging Intestinal Mucosa Eosinophilic esophagitis Intensive care medicine Child Health related quality of life Mouth medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Eosinophilic Esophagitis medicine.disease Patient Satisfaction Long term monitoring 030211 gastroenterology & hepatology Female Esophagoscopy medicine.symptom business Esophagitis |
| Popis: | Unsedated transnasal endoscopy (TNE) is safer and less costly than sedated EGD. The aim of this study was to evaluate the performance of TNE with biopsies in monitoring the esophageal mucosa of pediatric patients with eosinophilic esophagitis.Patients between 8 and 17 years of age with eosinophilic esophagitis and their parents were enrolled. Unsedated TNE was performed. A 2.8-mm (1.2-mm channel) or a 4-mm flexible bronchoscope (2-mm channel) was used, and esophageal biopsy specimens were obtained. Biopsy specimen analysis, duration, adverse events, and billing charges of TNE were assessed. Immediately after TNE and a minimum of 2 weeks later, a modified Group Health Association of America 9 survey and a preference questionnaire were completed, respectively.Twenty-one of 22 enrolled patients underwent TNE. TNE was performed with no serious adverse events. Histopathological analysis revealed 0 eosinophils per high-power field (n = 12), fewer than 15 eosinophils per high-power field (n = 4), and more than 15 eosinophils per high-power field (n = 5). The total epithelial surface area of mucosal biopsy samples from either TNE Forceps (1.2 mm or 2 mm biopsy channel forceps) compared with those obtained during the subject's previous EGD by using standard endoscopic forceps was not statistically different (P = .308 [1.2 mm]/P = .492 [2 mm]). All parents and 76.2% of subjects would undergo the TNE again. TNE was preferred over EGD by 85.7% of parents and 52.4% of subjects. The modified Group Health Association of America 9 survey revealed a high degree of satisfaction (average, 43.19 ± 2.6; maximum score, 45). Charges associated with TNE were 60.1% lower than for previous EGDs.Unsedated TNE is an effective, lower-cost procedure for monitoring the esophageal mucosa of children with eosinophilic esophagitis. |
| Databáze: | OpenAIRE |
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