Unsedated small-caliber esophagogastroduodenoscopy (EGD) versus conventional EGD: a comparative study

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Devices

Background:

• Sedation for esophagogastroduodenoscopy (EGD) contributes significantly to procedure costs and potential complications.
• Exploring alternatives to sedated EGD is crucial for improving patient safety and healthcare economics.

Purpose of the Study:

• To evaluate the feasibility, patient acceptability, and diagnostic accuracy of unsedated small-caliber transoral EGD (sc-EGD).

Main Methods:

• A four-phase study involving healthy volunteers and patients.
• Technical feasibility and tolerability of sedated and unsedated sc-EGD were assessed.
• Diagnostic accuracy was compared against conventional EGD (c-EGD) using blinded endoscopists.

Main Results:

• Unsedated sc-EGD demonstrated high technical feasibility and tolerability in volunteers and patients.
• Diagnostic accuracy for unsedated sc-EGD was 97%, comparable to sedated conventional EGD.
• Patient acceptability was high, with 98% willing to repeat the unsedated procedure; no complications were reported.

Conclusions:

• Unsedated sc-EGD is a safe, effective, and well-tolerated endoscopic procedure.
• This approach offers a potential strategy to reduce the economic burden and risks linked to sedation in EGD.