BACKGROUND: Unsedated endoscopy has not gained wide acceptance in the United States. Factors that may predict tolerance and acceptance of unsedated endoscopy are ill defined. METHODS: Outpatients referred for standard EGD were recruited to undergo unsedated ultrathin esophagoscopy (UUE) with a new 3.1-mm battery-powered esophagoscope before sedated EGD. They rated preprocedure and postprocedure anxiety levels with the Profile of Mood States Tension/Anxiety subscale (POMS-SF T/A). They also rated symptoms and overall acceptability and listed procedural preference between EGD and UUE. Patients who refused UUE noted a reason for refusal and also completed the anxiety questionnaire. RESULTS: Fifty-two of 98 patients recruited agreed to participate, and underwent both UUE and EGD. Patients who refused UUE were significantly more anxious (mean anxiety score, 8.2 vs. 4.5, p < 0.005). Participants reported no significant difference between preprocedural (4.6 vs. 5.3) or postprocedural (3.5 vs. 2.6) anxiety for UUE versus standard EGD. After undergoing both procedures, only 46% stated they would prefer UUE to EGD in the future. Patients who chose the peroral approach were more likely to prefer UUE than those who chose the transnasal approach (58% vs. 23%, p = 0.02). CONCLUSIONS: Patient acceptance of unsedated endoscopy even with an ultrathin instrument is limited. Anxiety assessment by the POMS-SF T/A can identify patients willing to undergo UUE. Patients who choose transoral UUE may be more willing to repeat the procedure.
BACKGROUND: Unsedated endoscopy has not gained wide acceptance in the United States. Factors that may predict tolerance and acceptance of unsedated endoscopy are ill defined. METHODS: Outpatients referred for standard EGD were recruited to undergo unsedated ultrathin esophagoscopy (UUE) with a new 3.1-mm battery-powered esophagoscope before sedated EGD. They rated preprocedure and postprocedure anxiety levels with the Profile of Mood States Tension/Anxiety subscale (POMS-SF T/A). They also rated symptoms and overall acceptability and listed procedural preference between EGD and UUE. Patients who refused UUE noted a reason for refusal and also completed the anxiety questionnaire. RESULTS: Fifty-two of 98 patients recruited agreed to participate, and underwent both UUE and EGD. Patients who refused UUE were significantly more anxious (mean anxiety score, 8.2 vs. 4.5, p < 0.005). Participants reported no significant difference between preprocedural (4.6 vs. 5.3) or postprocedural (3.5 vs. 2.6) anxiety for UUE versus standard EGD. After undergoing both procedures, only 46% stated they would prefer UUE to EGD in the future. Patients who chose the peroral approach were more likely to prefer UUE than those who chose the transnasal approach (58% vs. 23%, p = 0.02). CONCLUSIONS:Patient acceptance of unsedated endoscopy even with an ultrathin instrument is limited. Anxiety assessment by the POMS-SF T/A can identify patients willing to undergo UUE. Patients who choose transoral UUE may be more willing to repeat the procedure.
Authors: Anne F Peery; Toshitaka Hoppo; Katherine S Garman; Evan S Dellon; Norma Daugherty; Susan Bream; Alejandro F Sanz; Jon Davison; Melissa Spacek; Diane Connors; Ashley L Faulx; Amitabh Chak; James D Luketich; Nicholas J Shaheen; Blair A Jobe Journal: Gastrointest Endosc Date: 2012-03-16 Impact factor: 9.427
Authors: Christopher H Blevins; Jason S Egginton; Nilay D Shah; Michele L Johnson; Prasad G Iyer Journal: J Clin Gastroenterol Date: 2018 Nov/Dec Impact factor: 3.062
Authors: Joel A Friedlander; Emily M DeBoer; Jason S Soden; Glenn T Furuta; Calies D Menard-Katcher; Dan Atkins; David M Fleischer; Robert E Kramer; Robin R Deterding; Kelley E Capocelli; Jeremy D Prager Journal: Gastrointest Endosc Date: 2015-07-02 Impact factor: 9.427