Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Abstract

Aim: To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy.

Methods: We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis.

Results: A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G. Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett's esophagus, and 0.909 for esophageal varices.

Conclusion: Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy.

Keywords: Endoscopy; Esophagoscopy; Esophagus; Transnasal.

Figures

Figure 1

Components of the E.G. Scan™ system (first generation). A: A probe containing the camera capsule, bending module and data connector; B: A controller; C: A display system with computer software to display the images (E. G. View™).

Figure 2

Examples of esophageal diseases detected with the E.G. Scan™. A: Large esophageal varices; B: Medium-small esophageal varices; C: Distal esophageal adenocarcinoma; D: Esophageal angiodysplasia.

Figure 3

Barrett’s esophagus images obtained with E.G. Scan™. A and B: Barrett’s without dysplasia; C and D: Barrett’s esophagus with low-grade dysplasia.

Figure 4

Gastric images obtained with E.G. Scan™. A: Portal hypertension gastropathy; B: Bile reflux gastritis.

Figure 5

Duodenal images obtained with E.G. Scan™. A: Normal duodenum; B: Mild duodenitis; C and D: Celiac disease.