Dollin Yeshai T, Mark Jacob A, Andrews Rachel, Pan Zhaoxing, Ort Courtney, Kramer Robert E, Nguyen Nathalie
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA.
J Pediatr Gastroenterol Nutr. 2025 Jul;81(1):140-145. doi: 10.1002/jpn3.70061. Epub 2025 May 4.
Unsedated transnasal esophagoscopy (TNE) is an innovative and minimally invasive technique becoming more commonplace in pediatric gastroenterology. The advantages include no anesthesia, decreased cost, and less time away from work and school. There is no published data evaluating postprocedure adverse events (AE) with TNE. The aim of this study was to evaluate postprocedure AE associated with TNE compared to sedated esophagogastroduodenoscopy (EGD).
AE data were prospectively collected for patients ages 5-22 years who underwent endoscopy at a tertiary children's hospital between January 2015 and June 2022. Demographic data and procedural factors were collected, and AE were categorized using a standardized scoring system.
A total of 10,023 diagnostic EGD's on 7786 patients and 927 TNE's on 492 patients were performed. The total number of AE (Grade I-IV) observed were 196 after EGD and 1 after TNE. The total AE rate for EGD's was significantly higher than for TNE's (1.96% vs. 0.11%, p < 0.0001). The clinically significant AE (Grade II or higher) for EGD's was higher than TNE's (0.67% vs. 0%, p = 0.006). In controlling for eosinophilic esophagitis (EoE) as the indication, the total AE and the clinically significant AE for EGD's were higher than TNE's ([1.87% vs. 0.12% p < 0.001], [0.75% vs. 0% p = 0.01]).
The postprocedure AE rate for TNE was lower than EGD both for overall and clinically significant AE. This suggests TNE is a safer approach for monitoring esophageal pathology than sedated EGD for patients who can undergo TNE.
非镇静经鼻食管镜检查（TNE）是一种创新的微创技术，在儿科胃肠病学中越来越普遍。其优点包括无需麻醉、成本降低以及减少误工和缺课时间。目前尚无已发表的数据评估TNE术后不良事件（AE）。本研究的目的是评估与镇静食管胃十二指肠镜检查（EGD）相比，TNE术后的AE。
前瞻性收集2015年1月至2022年6月在一家三级儿童医院接受内镜检查的5至22岁患者的AE数据。收集人口统计学数据和操作因素，并使用标准化评分系统对AE进行分类。
共对7786例患者进行了10023次诊断性EGD，对492例患者进行了927次TNE。EGD后观察到的AE（I-IV级）总数为196例，TNE后为1例。EGD的总AE发生率显著高于TNE（1.96%对0.11%，p<0.0001）。EGD的临床显著AE（II级或更高）高于TNE（0.67%对0%，p=0.006）。在将嗜酸性食管炎（EoE）作为适应证进行控制时，EGD的总AE和临床显著AE高于TNE（[1.87%对0.12%，p<0.001]，[0.75%对0%，p=0.01]）。
无论是总体AE还是临床显著AE，TNE术后的AE发生率均低于EGD。这表明对于能够接受TNE的患者，监测食管病变时，TNE是一种比镇静EGD更安全的方法。
