Prospective comparative evaluation of video US endoscope

Background: Limitations in the technical capabilities of the fiberoptic ech oendoscope often necessitate concurrent diagnostic endoscopy at the time of an endosonographic (EUS) examination. Our aim was to determine whether a n ew video echoendoscope would allow the performance of EUS without diagnosti c endoscopy. Methods: EUS examinations on all patients at two centers were initiated wit h a fiberoptic echoendoscope (period of 5 weeks) or a video echoendoscope ( period of 6 weeks). Note was made of need for concurrent diagnostic endosco py. The endosonographer also rated the mechanical, optical, and sonographic performance of the video instrument using a 9-point comparative scale (1 = much worse, 5 = equal to, and 9 = much better than fiberoptic echoendoscop e). Results: A total of 103 patients including 40 and 28 with mural lesions and 22 and 15 with retroperitoneal lesions were examined with the fiberoptic a nd video echoendoscopes, respectively. Mean values for parameters rating th e video echoendoscope's mechanical performance ranged between 5.0 and 5.9, optical performance ranged between 6.6 and 7.5, and sonographic performance ranged between 4.6 and 4.9. Concurrent diagnostic endoscopy was required l ess frequently when patients with mural lesions (18% vs. 70%, p < 0.005) or patients with retroperitoneal lesions (0% vs. 14%, p = no significance) we re examined with the video echoendoscope compared with the fiberoptic echoe ndoscope. Conclusions: Moderately improved optics and slightly better mechanical char acteristics of the new video echoendoscope allow the performance of EUS wit hout concurrent diagnostic endoscopy in the majority of patients.