経鼻上部消化管内視鏡検査の初期経験について

Abstract

We performed transnasal endoscopy using a small-caliber electric scope (EG- 470N5, Fujinon-Toshiba System Co.) with a tip diameter of 5.9 ㎜ (the conventional electric scope has a tip diameter of 9-10 ㎜) which was developed for minimally invasive examination. Transnasal endoscopy was perfomed on 68 patients and we gathered information through a questionnaire regarding suffering during the examination, the patient's choice for the next examination (transoral or transnasal method), and the necessity of the small-caliber electric scope. The procedure was successful in 66 patients (97%), with no severe complications. We performed the esophago-gastro-duodenoscopy with no difficulty in maneuverability, observability, or pathologic diagnosis from biopsy specimens. We were able to observe the pharynx including Waldeyer's tonsillar ring and the larynx with distinct pictures. Conversation between the endoscopist and patient was possible during the procedure in a relaxed mood. The results of the questionnaire were that 27 patients (41%) reported nasal pain, but 60 patients (91%) chose transnasal endoscopy for the next examination. Sixty-four patients (97%) confirmed the necessity of the small-caliber electric scope. Moreover, we successfully passed severe stenotic lesions and performed a transcutaneous gastrostomy assisted by endoscope in a patient suffering advanced esophageal cancer. Conclusively, transnasal endoscopy in upper gastrointestinal examinations was very useful in reducing the disco㎡ort of the patient compared with the conventional method and had high necessity for many patients. We can expect the detection of early pharyngeal and laryngeal cancer, and application to various endoscopic therapy, in the future.