Present status and the future of ultrathin endoscopy

Endoscopic population‐based screening for gastric cancer began in April 2016, and the use of transnasal ultrathin esophagogastroduodenoscopy (UT‐EGD) has rapidly become popular. With UT‐EGD, discomfort associated with an examination is reduced, patient satisfaction is high, and adverse effects on cardiopulmonary function are fewer. Consequently, UT‐EGD is a good option for gastric screening in an aging society. Because of the narrower diameter of the endoscope, however, image quality is inferior to that obtained using transoral conventional esophagogastroduodenoscopy (C‐EGD). As a result, lesions observed by UT‐EGD must be viewed at close proximity and chromoendoscopy should be used concurrently, which is burdensome for the endoscopist. Recent innovations by endoscope manufacturers have enabled dramatic improvements in transnasal UT‐EGD and facilitated Hi‐Vision imaging. Furthermore, image enhancement that allows for observation on a par with transoral C‐EGD is now feasible. In the future, UT‐EGD will be equipped with functions that permit magnified endoscopic image. It is anticipated that a multiroute transition between transnasal and transoral UT‐EGD will become possible.

[1]  T. Itoi,et al.  Linked color imaging effectively detects the endoscopic atrophic border in transnasal endoscopy , 2022, Journal of clinical biochemistry and nutrition.

[2]  T. Kawai.  Improved transnasal examination of the upper gastrointestinal tract through advancements in ultrathin endoscopes , 2021, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[3]  S. Ono,et al.  Tapering body stiffness shortens upper gastrointestinal examination via transoral insertion with ultrathin endoscope , 2020, Endoscopy International Open.

[4]  T. Kawano,et al.  Linked Color Imaging Focused on Neoplasm Detection in the Upper Gastrointestinal Tract , 2020, Annals of Internal Medicine.

[5]  K. Koike,et al.  Artificial intelligence versus expert endoscopists for diagnosis of gastric cancer in patients who have undergone upper gastrointestinal endoscopy , 2019, Endoscopy.

[6]  Mototsugu Kato,et al.  Linked Color Imaging and the Kyoto Classification of Gastritis: Evaluation of Visibility and Inter-Rater Reliability , 2019, Digestion.

[7]  Taketo Yamaguchi,et al.  Early gastric cancer diagnostic ability of ultrathin endoscope loaded with laser light source , 2019, World journal of gastroenterology.

[8]  M. Fujishiro,et al.  Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images , 2018, Gastric Cancer.

[9]  K. Murakami,et al.  Objective Endoscopic Analysis with Linked Color Imaging regarding Gastric Mucosal Atrophy: A Pilot Study , 2017, Gastroenterology research and practice.

[10]  Yuji Naito,et al.  Linked color imaging improves endoscopic diagnosis of active Helicobacter pylori infection , 2016, Endoscopy International Open.

[11]  Hisao Tajiri,et al.  Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA‐G) , 2016, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[12]  K. Kurashina,et al.  Relationship between the Degree of Endoscopic Atrophy of the Gastric Mucosa and Carcinogenic Risk , 2015, Digestion.

[13]  T. Gotoda,et al.  Evaluation of gastric cancer diagnosis using new ultrathin transnasal endoscopy with narrow‐band imaging: Preliminary study , 2014, Journal of gastroenterology and hepatology.

[14]  N. Yamamichi,et al.  Evaluation of preferable insertion routes for esophagogastroduodenoscopy using ultrathin endoscopes. , 2014, World journal of gastroenterology.

[15]  N. Yamamichi,et al.  Ultrathin endoscope flexibility can predict discomfort associated with unsedated transnasal esophagogastroduodenoscopy. , 2013, World journal of gastrointestinal endoscopy.

[16]  T. Gotoda,et al.  Evolution of ultrathin endoscope , 2013, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[17]  T. Itoi,et al.  Narrow‐band imaging on screening of esophageal lesions using an ultrathin transnasal endoscopy , 2012, Journal of gastroenterology and hepatology.

[18]  T. Tahara,et al.  Usefulness of transnasal endoscopy where endoscopic submucosal dissection is difficult , 2011, Gastric Cancer.

[19]  D. Kim,et al.  Transnasal endoscope-assisted endoscopic submucosal dissection for gastric adenoma and early gastric cancer in the pyloric area: a case series , 2010, Endoscopy.

[20]  Kazuhide Yamamoto,et al.  ADVANTAGES OF USING THIN ENDOSCOPE‐ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE FOR LARGE COLORECTAL TUMORS , 2010, Digestive Endoscopy.

[21]  K. Murakami,et al.  Evaluation of esophageal function in patients with gastroesophageal reflux disease using transnasal endoscopy , 2009, Journal of gastroenterology and hepatology.

[22]  M. Yamagata,et al.  A Randomized Prospective Trial Comparing Unsedated Endoscopy via Transnasal and Transoral Routes Using 5.5-mm Video Endoscopy , 2009, Digestive Diseases and Sciences.

[23]  H. Arakawa,et al.  Ultrathin endoscopy versus high-resolution endoscopy for diagnosing superficial gastric neoplasia. , 2009, Gastrointestinal endoscopy.

[24]  K. Okada,et al.  COMPARISON OF THE DIAGNOSTIC UTILITY OF THE ULTRATHIN ENDOSCOPE AND THE CONVENTIONAL ENDOSCOPE IN EARLY GASTRIC CANCER SCREENING , 2009, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[25]  Pei-Jen Lou,et al.  Transnasal endoscopy with narrow-band imaging and Lugol staining to screen patients with head and neck cancer whose condition limits oral intubation with standard endoscope (with video). , 2009, Gastrointestinal endoscopy.

[26]  T. Itoi,et al.  Impact of transnasal ultrathin esophagogastroduodenoscopy (UT‐EGD) in the evaluation of esophageal peristaltic function , 2008, Journal of Gastroenterology and Hepatology.

[27]  Y. Hayami,et al.  COMPARISON OF ENDOSCOPIC DETECTION RATE OF EARLY GASTRIC CANCER AND GASTRIC ADENOMA USING TRANSNASAL EGD WITH THAT OF TRANSORAL EGD , 2008 .

[28]  F. Itokawa,et al.  Efficacy and safety of 1-step transnasal endoscopic nasobiliary drainage for the treatment of acute cholangitis in patients with previous endoscopic sphincterotomy (with videos). , 2008, Gastrointestinal endoscopy.

[29]  J. Watari,et al.  Transnasal ultrathin endoscopy for placement of a long intestinal tube in patients with intestinal obstruction. , 2008, Gastrointestinal endoscopy.

[30]  M. Okuno,et al.  Transnasal endoscopic retrograde chalangiopancreatography using an ultrathin endoscope: a prospective comparison with a routine oral procedure. , 2008, World journal of gastroenterology.

[31]  M. Okuno,et al.  Autonomic nervous function in upper gastrointestinal endoscopy: A prospective randomized comparison between transnasal and oral procedures , 2008, Journal of Gastroenterology.

[32]  Jun Kato,et al.  Thin endoscope-assisted endoscopic submucosal dissection for large colorectal tumors (with videos). , 2007, Gastrointestinal endoscopy.

[33]  S. Roman,et al.  Prospective evaluation of a new ultrathin one-plane bending videoendoscope for transnasal EGD: a comparative study on performance and tolerance. , 2007, Gastrointestinal endoscopy.

[34]  T. Itoi,et al.  Comparison of the effects on cardiopulmonary function of ultrathin transnasal versus normal diameter transoral esophagogastroduodenoscopy in Japan. , 2007, Hepato-gastroenterology.

[35]  H. Nawata,et al.  Prospective randomized trial of transnasal versus peroral endoscopy using an ultrathin videoendoscope in unsedated patients , 2007, Journal of gastroenterology and hepatology.

[36]  Sergio Sartori,et al.  Unsedated ultrathin upper endoscopy is better than conventional endoscopy in routine outpatient gastroenterology practice: a randomized trial. , 2007, World journal of gastroenterology.

[37]  Y. Kinoshita,et al.  A prospective randomized comparative study on the safety and tolerability of transnasal esophagogastroduodenoscopy. , 2005, Endoscopy.

[38]  S. Rogers,et al.  Unsedated ultrathin EGD is well accepted when compared with conventional sedated EGD: a multicenter randomized trial. , 2003, Gastroenterology.

[39]  H. Neuhaus,et al.  A Randomized Trial of Unsedated Transnasal Small-Caliber Esophagogastroduodenoscopy (EGD) versus Peroral Small-Caliber EGD versus Conventional EGD , 2003, Endoscopy.

[40]  Thierry Ponchon,et al.  Unsedated transnasal EGD in daily practice: results with 1100 consecutive patients. , 2003, Gastrointestinal endoscopy.

[41]  M. Fennerty,et al.  A randomized trial of peroral versus transnasal unsedated endoscopy using an ultrathin videoendoscope. , 1999, Gastrointestinal endoscopy.

[42]  J. Dent,et al.  A comparison of transnasal and transoral endoscopy with small-diameter endoscopes in unsedated patients. , 1999, Gastrointestinal endoscopy.

[43]  A. Montserrat,et al.  Transnasal Gastroscopy Compared to Conventional Gastroscopy: A Randomized Study of Feasibility, Safety, and Tolerance , 1998, Endoscopy.

[44]  R. Shaker,et al.  A comparative study of unsedated transnasal esophagogastroduodenoscopy and conventional EGD. , 1996, Gastrointestinal endoscopy.

[45]  T. Marek,et al.  Prospective comparison of nasal versus oral insertion of a thin video endoscope in healthy volunteers. , 1996, Endoscopy.

[46]  T. Takemoto,et al.  An Endoscopic Recognition of the Atrophic Border and its Significance in Chronic Gastritis , 1969 .

[47]  T. Tahara,et al.  Endoscopic submucosal dissection of an esophageal tumor using a transnasal endoscope without sedation , 2014, Endoscopy.

[48]  F. Moriyasu,et al.  Diagnosis of Esophageal and Gastric Carcinoma Using Transnasal Ultrathin Esophagogastroduodenoscopy , 2008 .

[49]  J. Hasford,et al.  A Prospective Randomized Comparison of Unsedated Ultrathin Versus Standard Esophagogastroduodenoscopy in Routine Outpatient Gastroenterology Practice: Does It Work Better through the Nose? , 2003, Endoscopy.

[50]  R. P. Blankfield,et al.  Helicobacter pylori infection and the development of gastric cancer. , 2001, The New England journal of medicine.