2008 Volume 50 Issue 12 Pages 3076-3088
Endoscopic GI cancer screening with transnasal esopahagogatroduodenoscopy (EGD) has been increasingly performed in Japan, in patients anticipating comfortable unsedated EGD. It is very important to do systematic medical interview and informed consents before the examination for maintaining its safety and quality in a high level. As 2 minute nasal anesthesia, we perform the anesthesia using one catheter (one stick method) after intranasal administration of naphazoline nitrate. The understanding of transnasal insertion is facilitated by the previous orientation of the nasal septum direction and image training with the upside down nasal cavity anatomical chart. If the scope insertion is difficult by the transnasal route, the insertion should be performed by transoral route. Precise examination with the optimal observation distance should be defined for transnasal EGD, taking into consideration its poor illumination especially in the far distance and narrow field of view. In endoscopic GI cancer screening with transnasal EGD, contents and methods of appropriate informed consents should be deliberated as well as effort to improve its diagnostic accuracy.
