Prospective evaluation of a new ultrathin one-plane bending videoendoscope for transnasal EGD: a comparative study on performance and tolerance

BackgroundEGD, with small-diameter endoscopes, is routinely performed via a nasal route in adults.ObjectiveTo evaluate a new ultrathin one-plane bending videoendoscope for transnasal EGD.DesignSingle center, prospective, randomized study.SettingEdouard Herriot University Hospital.PatientsA total of 122 outpatients (median age, 49 years [18-81 years], 62 men and 60 women) were randomized into 2 groups (on a 2:1 basis) according to the endoscope used: (1) a standard 5.9-mm-diameter videoendoscope (80 patients) or (2) a one-plane bending high resolution 4.9-mm-diameter videoendoscope (42 patients).Main Outcome MeasurementsThe operator assessed the quality of examination by using standard scores or a 100-mm visual scale. Patients quantified tolerance by using a 100-mm visual scale.ResultsThe duration of the procedure was the same in each group. The feasibility of transnasal insertion was significantly higher when using the 4.9-mm-diameter endoscope (97.61% [41/42 patients] vs 88.75% [71/80 patients], P < .05). The tolerance of EGD was significantly better in the group with the small videoendoscope, for global discomfort, pain, belching, and bloating. Similarly, acceptation of a new EGD in similar conditions was higher in group 2 (92.9% vs 80%, P < .05). The quality of examination (global, lavage, inflation, suction) was not different between the 2 groups.LimitationsEvaluation of patient tolerance and quality of examination was based on subjective features.ConclusionsAvailability of a new ultrathin one-plane bending videoendoscope represents a major technical improvement for transnasal EGD, which significantly improves both feasibility and patient tolerance, without affecting the quality of the examination.