Kim Charles Y, O'Rourke Robert W, Chang Eugene Y, Jobe Blair A
Department of Surgery, Oregon Health and Science University, Portland Veteran's Administration Medical Center, Portland, Oregon 97207, USA.
Surg Innov. 2006 Mar;13(1):31-9. doi: 10.1177/155335060601300106.
Although conventional esophagogastroduodenoscopy has become widespread in its applications and availability, it is constrained by the requirement for patient sedation. This requirement contributes to morbidity, time lost from work, and additional resource utilization in personnel and facilities. Small-caliber endoscopy is an emerging technology that enables transnasal evaluation of the upper gastrointestinal tract in a unsedated patient. This procedure can be performed in a wider range of settings, including the clinic setting where a dedicated conscious sedation suite is not available and can be incorporated into the office visit. The applications of small-caliber endoscopy include general diagnostic upper endoscopy, screening and surveillance of Barrett esophagus, and intraoperative diagnostics or postoperative evaluation of the upper gastrointestinal tract. Therapeutic applications include the placement of nasoduodenal feeding tubes, esophageal pH catheters, and impedance catheters. When used in the sedated patient, small-caliber endoscopy can also facilitate esophageal stricture dilation and transnasal placement of a percutaneous endoscopic gastrostomy tube. This review discusses the techniques, equipment, and applications of small-caliber endoscopy of the upper gastrointestinal tract.
尽管传统的食管胃十二指肠镜检查在应用和普及方面已十分广泛，但它受到患者镇静需求的限制。这种需求导致了发病率增加、工作时间损失以及人员和设施方面额外的资源利用。小口径内镜检查是一项新兴技术，能够在未镇静的患者中对上消化道进行经鼻评估。该操作可以在更广泛的环境中进行，包括没有专用清醒镇静套房的诊所环境，并且可以纳入门诊就诊过程。小口径内镜检查的应用包括一般诊断性上消化道内镜检查、巴雷特食管的筛查和监测，以及上消化道的术中诊断或术后评估。治疗应用包括放置鼻十二指肠喂养管、食管pH导管和阻抗导管。当用于镇静患者时，小口径内镜检查还可以促进食管狭窄扩张和经鼻放置经皮内镜下胃造口管。本文综述讨论了上消化道小口径内镜检查的技术、设备和应用。
