[Ultra-thin transnasal esophagogastroduodenoscopy]

Area of Science:

• Gastroenterology
• Endoscopic Procedures

Context:

• Transnasal esophagogastroduodenoscopy (TN-EGD) is an emerging technique aiming to improve patient tolerance.
• Conventional transoral EGD (TO-EGD) remains the standard, but can cause significant pharyngeal discomfort.

Purpose:

• To evaluate the characteristics and applications of ultra-thin TN-EGD.
• To compare TN-EGD with TO-EGD regarding patient comfort and technical performance.

Summary:

• Ultra-thin TN-EGD is reported to reduce pharyngeal discomfort and enhance patient tolerability.
• Image quality, suction, air insufflation, and lens washing may be inferior in TN-EGD compared to TO-EGD due to smaller caliber.
• Optimal TN-EGD requires slow advancement, short-distance observation, and image-enhanced endoscopy (chromoendoscopy, NBI, i-scan, FICE).
• TN-EGD is applicable in various GI procedures including gastrostomy, feeding tube placement, ERCP with nasobiliary drainage, and small bowel obstruction management.

Impact:

• TN-EGD presents a more tolerable option for patients undergoing upper GI endoscopy.
• Technological advancements and specific techniques can mitigate the limitations of TN-EGD.
• The findings guide the appropriate application and technique optimization for TN-EGD in clinical practice.