A Prospective, Blinded Study of Diagnostic Esophagoscopy with a Superthin, Stand-Alone, Battery-Powered Esophagoscope

Mahesh S. Mokhashi, Stephan M. Wildi, Tammy F. Glenn, Michael B. Wallace, Christian Jost, Bora Gumustop, Christopher Y. Kim, Peter B. Cotton, Robert H. Hawes

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVES: A more widely available, well-tolerated, and cost-effective technique is needed to screen a broad population at risk for esophageal cancer. An ideal solution might be to perform unsedated esophagoscopy with an entirely self-contained, small-caliber endoscope. In a prospective, blinded study in three phases, we compared the feasibility, patient tolerance, and diagnostic accuracy of esophagoscopy performed with a prototype, superthin, battery-powered esophagoscope (BPE) with standard video esophagogastroduodenoscopy (SVE). METHODS: In phase I, 10 healthy volunteers underwent both peroral and transnasal esophagoscopy with BPE to evaluate the technical feasibility of the examination. For phases II and III, patients were recruited to have BPE before SVE. In phase II, both procedures were performed with conscious sedation. In phase III, the BPE was performed with only topical anesthesia. Two endoscopists assessed the technical performance of the endoscope and patient tolerance and recorded the esophageal findings independently. RESULTS: In phase I, all endoscopists reported adequate visualization of the esophagus in the 10 volunteers. A total of 181 patients were evaluated in phases II and III (89 in phase II, 92 in phase III). The sensitivity for detecting columnar lined esophagus was 94% in phase II and 95% in phase III. The sensitivity for all esophageal findings was 87% and 86% in phases II and III, respectively. The technical performance of the endoscope was significantly worse for BPE compared with the SVE. The patient tolerance as evaluated by the endoscopist was similar for both procedures. Ninety-five percent of the patients undergoing unsedated BPE were willing to have the procedure repeated under similar circumstances. CONCLUSIONS: Unsedated esophagoscopy with a 3.1-mm, battery-powered, stand-alone esophagoscope is feasible, well tolerated, and accurate in detecting esophageal pathologies. It might be an efficient and cost-effective screening tool for the detection of columnar lined esophagus.

Original languageEnglish (US)
Pages (from-to)2383-2389
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume98
Issue number11
DOIs
StatePublished - Nov 2003
Externally publishedYes

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Esophagoscopes
Esophagoscopy
Prospective Studies
Digestive System Endoscopy
Endoscopes
Esophagus
Conscious Sedation
Costs and Cost Analysis
Esophageal Neoplasms
Volunteers
Healthy Volunteers
Anesthesia
Pathology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A Prospective, Blinded Study of Diagnostic Esophagoscopy with a Superthin, Stand-Alone, Battery-Powered Esophagoscope. / Mokhashi, Mahesh S.; Wildi, Stephan M.; Glenn, Tammy F.; Wallace, Michael B.; Jost, Christian; Gumustop, Bora; Kim, Christopher Y.; Cotton, Peter B.; Hawes, Robert H.

In: American Journal of Gastroenterology, Vol. 98, No. 11, 11.2003, p. 2383-2389.

Research output: Contribution to journalArticle

Mokhashi, MS, Wildi, SM, Glenn, TF, Wallace, MB, Jost, C, Gumustop, B, Kim, CY, Cotton, PB & Hawes, RH 2003, 'A Prospective, Blinded Study of Diagnostic Esophagoscopy with a Superthin, Stand-Alone, Battery-Powered Esophagoscope', American Journal of Gastroenterology, vol. 98, no. 11, pp. 2383-2389. https://doi.org/10.1111/j.1572-0241.2003.08701.x
Mokhashi, Mahesh S. ; Wildi, Stephan M. ; Glenn, Tammy F. ; Wallace, Michael B. ; Jost, Christian ; Gumustop, Bora ; Kim, Christopher Y. ; Cotton, Peter B. ; Hawes, Robert H. / A Prospective, Blinded Study of Diagnostic Esophagoscopy with a Superthin, Stand-Alone, Battery-Powered Esophagoscope. In: American Journal of Gastroenterology. 2003 ; Vol. 98, No. 11. pp. 2383-2389.
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abstract = "OBJECTIVES: A more widely available, well-tolerated, and cost-effective technique is needed to screen a broad population at risk for esophageal cancer. An ideal solution might be to perform unsedated esophagoscopy with an entirely self-contained, small-caliber endoscope. In a prospective, blinded study in three phases, we compared the feasibility, patient tolerance, and diagnostic accuracy of esophagoscopy performed with a prototype, superthin, battery-powered esophagoscope (BPE) with standard video esophagogastroduodenoscopy (SVE). METHODS: In phase I, 10 healthy volunteers underwent both peroral and transnasal esophagoscopy with BPE to evaluate the technical feasibility of the examination. For phases II and III, patients were recruited to have BPE before SVE. In phase II, both procedures were performed with conscious sedation. In phase III, the BPE was performed with only topical anesthesia. Two endoscopists assessed the technical performance of the endoscope and patient tolerance and recorded the esophageal findings independently. RESULTS: In phase I, all endoscopists reported adequate visualization of the esophagus in the 10 volunteers. A total of 181 patients were evaluated in phases II and III (89 in phase II, 92 in phase III). The sensitivity for detecting columnar lined esophagus was 94{\%} in phase II and 95{\%} in phase III. The sensitivity for all esophageal findings was 87{\%} and 86{\%} in phases II and III, respectively. The technical performance of the endoscope was significantly worse for BPE compared with the SVE. The patient tolerance as evaluated by the endoscopist was similar for both procedures. Ninety-five percent of the patients undergoing unsedated BPE were willing to have the procedure repeated under similar circumstances. CONCLUSIONS: Unsedated esophagoscopy with a 3.1-mm, battery-powered, stand-alone esophagoscope is feasible, well tolerated, and accurate in detecting esophageal pathologies. It might be an efficient and cost-effective screening tool for the detection of columnar lined esophagus.",
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AU - Wildi, Stephan M.

AU - Glenn, Tammy F.

AU - Wallace, Michael B.

AU - Jost, Christian

AU - Gumustop, Bora

AU - Kim, Christopher Y.

AU - Cotton, Peter B.

AU - Hawes, Robert H.

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N2 - OBJECTIVES: A more widely available, well-tolerated, and cost-effective technique is needed to screen a broad population at risk for esophageal cancer. An ideal solution might be to perform unsedated esophagoscopy with an entirely self-contained, small-caliber endoscope. In a prospective, blinded study in three phases, we compared the feasibility, patient tolerance, and diagnostic accuracy of esophagoscopy performed with a prototype, superthin, battery-powered esophagoscope (BPE) with standard video esophagogastroduodenoscopy (SVE). METHODS: In phase I, 10 healthy volunteers underwent both peroral and transnasal esophagoscopy with BPE to evaluate the technical feasibility of the examination. For phases II and III, patients were recruited to have BPE before SVE. In phase II, both procedures were performed with conscious sedation. In phase III, the BPE was performed with only topical anesthesia. Two endoscopists assessed the technical performance of the endoscope and patient tolerance and recorded the esophageal findings independently. RESULTS: In phase I, all endoscopists reported adequate visualization of the esophagus in the 10 volunteers. A total of 181 patients were evaluated in phases II and III (89 in phase II, 92 in phase III). The sensitivity for detecting columnar lined esophagus was 94% in phase II and 95% in phase III. The sensitivity for all esophageal findings was 87% and 86% in phases II and III, respectively. The technical performance of the endoscope was significantly worse for BPE compared with the SVE. The patient tolerance as evaluated by the endoscopist was similar for both procedures. Ninety-five percent of the patients undergoing unsedated BPE were willing to have the procedure repeated under similar circumstances. CONCLUSIONS: Unsedated esophagoscopy with a 3.1-mm, battery-powered, stand-alone esophagoscope is feasible, well tolerated, and accurate in detecting esophageal pathologies. It might be an efficient and cost-effective screening tool for the detection of columnar lined esophagus.

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