A RANDOMIZED STUDY ON THE TOLERABILITY AND ADVERSE EFFECT ON CARDIOPULMONARY PARAMETERS WITH ESOPHAGOGASTRODUODENOSCOPY BY SMALL CALIBER ENDOSCOPE

Abstract

[Purpose]Recently, small caliber upper gastrointestinal endoscope have been developed for transnasal insertion. However, tolerability and incidence of adverse effect of this procedure had not been fully investigated. The aims of this study were to investigate the effect of small caliber endoscope on cardiopulmonary function and to evaluate which route was more acceptable, transnasal or transoral. [Methods](1) A total of 195 patients who received esophagogastroduodenoscopy (EGD) was enrolled in this study. All patients were randomly assigned to one of three groups of EGD procedure : (i) transnasal EGD using a small caliber endoscope ; (ii) transoral EGD using the same small caliber endoscope ; (iii) transoral EGD using a conventional endoscope. The number of patients in each group was 65. Blood pressure, pulse rate, arterial oxygen saturation and gagging were monitored. (2) The next study involved 37 healthy volunteers who underwent EGD, both transnasal and transoral with small caliber endoscope . All volunteers were randomly assigned to two groups : one was firstly examinened by transnasal and the other was firstly examined by transoral. The cross-over study was done to evaluate the feasibility of two procedures between them. [Results]In the transnasal EGD group, the changes of blood pressure, pulse rate and the number of gagging episodes were significantly lower than other groups . The cross-over study showed that the transnasal EGD was slightly more tolerable than the transoral EGD in gagging episodes, choking and overall evaluation. [Conclusion]Transnasal EGD was safe with few adverse effects on cardiopulmonary function and was more tolerable than transoral EGD.