| Comparison of transnasal small-caliber vs. peroral conventional esophagogastroduodenoscopy for evaluating varices in unsedated cirrhotic patients. | |
MedLine Citation:
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PMID: 21660907 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND STUDY AIMS: We aimed to evaluate the accuracy of transnasal small-caliber esophagogastroduodenoscopy (TNSC-EGD) compared with peroral conventional EGD (POC-EGD) for evaluating varices in unsedated patients with liver cirrhosis. The success rate, safety, endoscopist satisfaction, and patient tolerability of TNSC-EGD were also addressed. PATIENTS AND METHODS: One hundred patients with liver cirrhosis participated in this randomized crossover trial, and 84 subjects completed both procedures. Of the 84 patients, 28 had marked bleeding diathesis (platelet count ≤ 50 000/mm (3) and/or prothrombin time ≥ 1.7 INR). Endoscopists and patients answered questionnaires using a 100-mm visual analog scale about, respectively, their satisfaction and their tolerance of the procedure. RESULTS: The success rate of TNSC-EGD was comparable to that of POC-EGD (96 % vs. 99 %). Nasal mucosal hemorrhages induced by TNSC-EGD occurred in 5 patients (6 %), but were easily controlled. Compared to the POC-EGD reference test, diagnostic accuracies of TNSC-EGD for detecting esophageal varices, gastric varices, and red color signs were 98 %, 98 %, and 96 %, respectively. Concordance rates on grading esophageal varices and gastric varices were excellent at 93 % (κ = 0.85) and 96 % (κ = 0.87). Endoscopist satisfaction was not significantly different between TNSC-EGD and POC-EGD, whereas patient tolerance of TNSC-EGD was significantly greater than that of POC-EGD (79.0 ± 14.4 vs. 69.5 ± 16.1; P = 0.001). CONCLUSION: TNSC-EGD without sedation was found to be feasible, safe, and accurate for evaluating esophageal varices, gastric varices, and red color signs in patients with cirrhosis - even in those with marked bleeding diathesis. Furthermore, it was significantly better tolerated by patients, without altering endoscopist satisfaction. Our findings indicate that TNSC-EGD without sedation might be viewed as a potential alternative to POC-EGD for evaluation of varices. |
Authors:
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W H Choe; J H Kim; S Y Ko; S Y Kwon; B K Kim; K H Rhee; T H Seo; T Y Lee; S N Hong; S-Y Lee; I K Sung; H S Park; C S Shim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-9 |
Journal Detail:
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Title: Endoscopy Volume: - ISSN: 1438-8812 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© Georg Thieme Verlag KG Stuttgart · New York. |
Affiliation:
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Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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