title: Prospective comparison between sedated high-definition oral and unsedated ultrathin transnasal esophagogastroduodenoscopy in the same subjects: pilot study.
abstract: BACKGROUND
  Recently, quality as well as acceptability has been a concern regarding endoscopy. The aim of the present study was to compare the acceptability and quality of sedated high-definition esophagogastroduodenoscopy (sHD-EGD) using a newly developed high-definition videoscope with those of unsedated ultrathin esophagogastroduodenoscopy (uUT-EGD) using a 5.2 mm videoscope.
  
  
  METHODS
  Twenty-two volunteers underwent both peroral sHD-EGD and transnasal uUT-EGD on the same day. Sedation consisted of 40 mg of propofol i.v. Both endoscopist and subject satisfaction levels were assessed using a 10 cm visual analogue scale.
  
  
  RESULTS
  All 22 subjects completed the sHD-EGD and 21 subjects completed the uUT-EGD. The endoscopist and subject satisfaction levels of sHD-EGD were significantly better than those of uUT-EGD (overall endoscopist satisfaction: 9 vs 4, P < 0.0001; overall subject satisfaction: 9 vs 3, P < 0.0001). The optical quality of the endoscopic images of sHD-EGD was significantly higher than that of uUT-EGD except in the duodenal bulb (overall quality: 8 vs 7, P < 0.0001). The interobserver agreement for EGD findings in sHD-EGD was better than with uUT-EGD, although the EGD findings in both sHD-EGD and uUT-EGD were similar. After undergoing both procedures, 91% were willing to have sHD-EGD again compared to 9% with uUT-EGD.
  
  
  CONCLUSIONS
  The endoscopist and subject satisfaction levels and image quality of sHD-EGD were better than those of uUT-EGD. The routine use of high-definition videoscopes would be expected to provide better acceptability than that obtained with unsedated endoscopy.
authors.affiliation: Department of Gastroenterology, Showa Inan General Hospital, Komagane, Japan. horiuchi.akira@sihp.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Nao
authors.initials: N
authors.lastname: Hidaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ichise
authors.forename: Masashi
authors.initials: M
authors.lastname: Kajiyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D016292:Procedural Sedation; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015742:Propofol; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015742:Propofol