Accuracy of a narrow-diameter battery-powered endoscope in sedated and unsedated patients.
BACKGROUND
Esophagoscopy with a portable battery-powered endoscope could provide a safe, inexpensive, and minimally invasive way to screen for Barrett's esophagus or esophageal varices. The use of such an instrument in an unsedated fashion has not been previously evaluated.


METHODS
Patients referred for an EGD were recruited to undergo an additional examination with the battery-powered endoscope before EGD. In phase 1, (n = 42) patients received conscious sedation before the battery-powered endoscopic examination. In phase 2, (n = 56) patients were not sedated and were given the option of a peroral (n = 43) or transnasal (n = 13) endoscopy. Examiners were blinded to patient history and procedure indications. Esophageal findings, ease of intubation, optical quality, and patient comfort for the battery-powered endoscope and standard EGD were recorded by the endoscopist.


RESULTS
Ninety-eight patients (60 men, 38 women, mean age 53 years) were recruited. The sensitivity for detecting Barrett's esophagus, esophageal tumors, and esophageal varices was 54.5%, 66.7%, and 80%, respectively. Ease of intubation and patient comfort as perceived by the endoscopist were not significantly different between the battery-powered endoscope and EGD. Optical quality was ranked as less than 4 (on a 5-point scale with 5 = standard EGD and 1 = poor) in 42% of battery-powered endoscopic examinations. There were no complications.


CONCLUSIONS
The accuracy of esophageal examination with a 3.1-mm endoscope is substantially inferior to standard EGD. Thus, the battery-powered endoscope would not be useful for screening patients for Barrett's esophagus or varices unless improvements in optical quality and visualization are made.
Catanzaro
Andrew
A
Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio 44106-1736, USA.
Faulx
Ashley
A
Pfau
Patrick R
PR
Cooper
Gregory
G
Isenberg
Gerard
G
Wong
Richard C K
RC
Sivak
Michael V
MV
Chak
Amitabh
A
D000328:Adult; D000368:Aged; D016292:Procedural Sedation; D004935:Esophageal Diseases / Q000175:diagnosis; D020701:Esophagoscopes; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity