PROSPECTIVE COMPARISON OF NASAL VERSUS ORAL INSERTION OF A THIN VIDEOENDOSCOPE IN HEALTHY-VOLUNTEERS

Background and Study Aims: Attempts have been made to improve patients ' tolerance of upper gastrointestinal endoscopy and to decrease the ne ed for sedation, using thinner endoscopes and a nasal introduction rou te, We prospectively compared the oral and nasal routes in volunteers, using a thin prototype video endoscope. Methods: Ten healthy voluntee rs underwent two upper gastrointestinal endoscopies in a random order on two different days, with the procedure being carried out by a singl e experienced endoscopist, Parameters assessed were the tolerance of s cope insertion and the assessment of the entire procedure (0-10 scale) , the method of insertion preferred by the volunteers, the completenes s of the examination (assessed by an independent endoscopist), and the time required for the procedure. Results: In one patient, nasal inser tion failed, and she was excluded from further analysis, The insertion of the scope was easier via the oral route, as reflected in a shorter examination time (mean 165 vs, 210 seconds, p = 0.017) and patients' tolerance for the scope insertion (mean score: 8 for oral vs, 4 for na sal route; p = 0.03), On the other hand, gagging occurred more frequen tly during oral endoscopy (6/9 vs 1/9, p = 0.05). Three of the volunte ers in each case preferred the oral or the nasal route, and three were not decided, in case of a repeated endoscopy. Similarly, the overall tolerance for the procedure did not differ between the two groups. Con clusion: Thin-diameter gastroscopes seem to improve patients' toleranc e, In this small study in volunteers, nasal introduction showed no ove rall benefit over oral introduction, Modifications of the scope to ach ieve better nasal passage are necessary.