Department of Medical Research, Gundersen Health System, La Crosse, WI, USA.
Department of Medical Education, Gundersen Health System, La Crosse, WI, USA.
Surg Endosc. 2021 Aug;35(8):4153-4159. doi: 10.1007/s00464-020-07892-y. Epub 2020 Aug 14.
Endoscopic evaluation is frequently performed before bariatric surgery to identify foregut pathology that may alter procedure selection. Transnasal endoscopy (TNE) is an alternative to esophagogastroduodenoscopy (EGD). The objective of this study was to compare TNE to EGD.
Patients who underwent TNE or EGD before bariatric surgery from January 2012 through April 2019 were reviewed. Statistical analyses included Chi-square, Wilcoxon two-sample, and Fisher's exact tests. A p value < 0.05 was considered significant.
Three hundred and forty-five patients underwent preoperative screening (63% EGD, 37% TNE) before bariatric surgery. Mean age and preoperative body mass index in the TNE and EGD groups were 46.2 ± 12.4 vs 45.5 ± 11.6 years (p = 0.58) and 46.5 ± 7.1 vs. 45.5 ± 6.1 kg/m (p = 0.25), respectively. Three TNEs were aborted, resulting in a success rate of 98%. Of patients who underwent EGD, 1 (0.5%) visited the emergency department (ED), and 7 (3%) called the nurse with post-procedure concerns. There were no ED visits or nurse calls from patients who underwent TNE. The median total time in the procedure room was 77 (57-97) min for EGD vs. 26 (8-33) min for TNE (p < 0.001). One patient who underwent TNE required subsequent EGD. Mean charge per patient for EGD and TNE was $5034.70 and $1464.00, respectively.
TNE was associated with less post-procedure care, shorter procedure time and fewer charges compared to EGD. TNE could be considered an initial screening tool for patients undergoing bariatric surgery, while EGD could be used selectively in patients with abnormal TNE findings.
减重手术前常进行内镜检查，以确定可能改变手术选择的上消化道病理学。经鼻内镜（TNE）是食管胃十二指肠镜（EGD）的替代方法。本研究的目的是比较 TNE 与 EGD。
回顾 2012 年 1 月至 2019 年 4 月间接受减重手术前 TNE 或 EGD 的患者。统计分析包括卡方检验、Wilcoxon 两样本检验和 Fisher 确切概率检验。p 值<0.05 被认为具有统计学意义。
345 例患者接受减重手术前筛查（63% EGD，37% TNE）。TNE 和 EGD 组的平均年龄和术前体重指数分别为 46.2±12.4 岁和 45.5±11.6kg/m2（p=0.58）和 46.5±7.1kg/m2 和 45.5±6.1kg/m2（p=0.25）。3 例 TNE 被中止，成功率为 98%。行 EGD 的患者中，1 例（0.5%）就诊于急诊（ED），7 例（3%）因术后不适致电护士。行 TNE 的患者中无 ED 就诊或护士来电。EGD 组的手术间总时间中位数为 77（57-97）min，而 TNE 组为 26（8-33）min（p<0.001）。1 例行 TNE 的患者随后需要行 EGD。EGD 和 TNE 的每位患者平均费用分别为 5034.70 美元和 1464.00 美元。
与 EGD 相比，TNE 术后护理较少，手术时间较短，费用较低。TNE 可作为接受减重手术患者的初始筛查工具，而 EGD 可选择性用于 TNE 检查结果异常的患者。
