Conventional EGD versus Small-caliber EGD : The Thinner, the Better?

Lee, Kang Moon; Chung, Woo Chul; Kim, You Joung; Lee, Bo In; Chang, U Im; Lee, Jin Sun; Yang, Jin Mo; Han, Sok Won; Choi, Kyu Yong; Chung, In Sik

Abstract

BACKGROUND/AIMS
Small-caliber esophagogastroduodenoscopy (scEGD) was developed to facilitate unsedated EGD, and has many advantages over sedated EGD in terms of costs and complications. This study compared the feasibility and tolerance of scEGD with unsedated conventional EGD (cEGD), and examined the effect of the endoscopic diameter on the patients' tolerance.
METHODS
A total of 114 patients who were referred for a diagnostic EGD was randomly allocated to undergo either scEGD (GIF XP260, Olympus, diameter 6.5 mm; n=57) or cEGD (GIF XQ240, Olympus, diameter 9.0 mm; n=57). After EGD, the patients and endoscopists completed questionnaires on the level of discomfort, satisfaction and acceptance of the examination.
RESULTS
Patients in the scEGD group reported significantly less discomfort (choking, pain and nausea) and more overall satisfaction than those in the cEGD group. Patients in the scEGD group were more willing to choose the same procedure again if medically indicated. According to multivariate analysis, the ultrathin endoscopic diameter itself was positively associated with the increased patients' satisfaction (odds ratio 3.07, p=0.003).
CONCLUSIONS
scEGD has comparable feasibility and accuracy but is more tolerable than cEGD. scEGD may have a role in clinical practice by minimizing the level of discomfort during unsedated EGD.