PROSPECTIVE COMPARISON BETWEEN SEDATED HIGH‐DEFINITION ORAL AND UNSEDATED ULTRATHIN TRANSNASAL ESOPHAGOGASTRODUODENOSCOPY IN THE SAME SUBJECTS: PILOT STUDY

Background: Recently, quality as well as acceptability has been a concern regarding endoscopy. The aim of the present study was to compare the acceptability and quality of sedated high‐definition esophagogastroduodenoscopy (sHD‐EGD) using a newly developed high‐definition videoscope with those of unsedated ultrathin esophagogastroduodenoscopy (uUT‐EGD) using a 5.2 mm videoscope. Methods: Twenty‐two volunteers underwent both peroral sHD‐EGD and transnasal uUT‐EGD on the same day. Sedation consisted of 40 mg of propofol i.v. Both endoscopist and subject satisfaction levels were assessed using a 10 cm visual analogue scale. Results: All 22 subjects completed the sHD‐EGD and 21 subjects completed the uUT‐EGD. The endoscopist and subject satisfaction levels of sHD‐EGD were significantly better than those of uUT‐EGD (overall endoscopist satisfaction: 9 vs 4, P < 0.0001; overall subject satisfaction: 9 vs 3, P < 0.0001). The optical quality of the endoscopic images of sHD‐EGD was significantly higher than that of uUT‐EGD except in the duodenal bulb (overall quality: 8 vs 7, P < 0.0001). The interobserver agreement for EGD findings in sHD‐EGD was better than with uUT‐EGD, although the EGD findings in both sHD‐EGD and uUT‐EGD were similar. After undergoing both procedures, 91% were willing to have sHD‐EGD again compared to 9% with uUT‐EGD. Conclusions: The endoscopist and subject satisfaction levels and image quality of sHD‐EGD were better than those of uUT‐EGD. The routine use of high‐definition videoscopes would be expected to provide better acceptability than that obtained with unsedated endoscopy.