The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: A prospective diagnostic pilot study

Sarmed S. Sami, Krish Ragunath, Emilie A. Wilkes, Martin James, Rodrigo Mansilla-Vivar, Jacobo Ortiz-Fernández-Sordo, Jonathan White, Amardeep Khanna, Marina Coletta, Sunil Samuel, Guruprasad P. Aithal, Indra Neil Guha

Research output: Contribution to journalArticle

Abstract

Background & Aims: Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan) compared to C-OGD as the reference standard. Methods: This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. Results: Forty-five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5% vs. 23.5%, P <0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P <0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60-0.95), and 0.78 (95% CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62-1.0), 0.97 (95% CI 0.84-1.0) respectively. No serious adverse events occurred. Conclusions: EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.

Original languageEnglish
Pages (from-to)1639-1648
Number of pages10
JournalLiver International
Volume36
Issue number11
DOIs
Publication statusPublished - 2016

Keywords

  • Endoscopy
  • Screening
  • Transnasal
  • Varices

ASJC Scopus subject areas

  • Hepatology

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    Sami, S. S., Ragunath, K., Wilkes, E. A., James, M., Mansilla-Vivar, R., Ortiz-Fernández-Sordo, J., White, J., Khanna, A., Coletta, M., Samuel, S., Aithal, G. P., & Guha, I. N. (2016). The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: A prospective diagnostic pilot study. Liver International, 36(11), 1639-1648. https://doi.org/10.1111/liv.13152