Abstract
Background and Study Aims: Attempts have been made to improve patients' tolerance of upper gastrointestinal
endoscopy and to decrease the need for sedation, using thinner endoscopes and a nasal
introduction route. We prospectively compared the oral and nasal routes in volunteers,
using a thin prototype video endoscope.
Methods: Ten healthy volunteers underwent two upper gastrointestinal endoscopies in a random
order on two different days, with the procedure being carried out by a single experienced
endoscopist. Parameters assessed were the tolerance of scope insertion and the assessment
of the entire procedure (0-10 scale), the method of insertion preferred by the volunteers,
the completeness of the examination (assessed by an independent endoscopist), and
the time required for the procedure.
Results: In one patient, nasal insertion failed, and she was excluded from further analysis.
The insertion of the scope was easier via the oral route, as reflected in a shorter
examination time (mean 165 vs. 210 seconds, p = 0.017) and patients' tolerance for
the scope insertion (mean score: 8 for oral vs. 4 for nasal route; p = 0.03). On the
other hand, gagging occurred more frequently during oral endoscopy (6/9 vs 1/9, p = 0.05).
Three of the volunteers in each case preferred the oral or the nasal route, and three
were not decided, in case of a repeated endoscopy. Similarly, the overall tolerance
for the procedure did not differ between the two groups.
Conclusion: Thin-diameter gastroscopes seem to improve patients' tolerance. In this small study
in volunteers, nasal introduction showed no overall benefit over oral introduction.
Modifications of the scope to achieve better nasal passage are necessary.
