Ultrathin Transnasal Esophagogastroduodenoscopy in Geriatric Patients: A Prospective Evaluation

Background: Ultrathin transnasal EGD is a very safe technique in common people. This study was conducted to explore the safety and tolerance of ultrathin transnasal esophagogastroduodenoscopy (EGD) in geriatric patients. Methods: A total of 327 patients referred for diagnostic transnasal EGD were allocated to three groups on the basis of age: group A (between 70 and 85 years), group B (older than 85 years), and control (younger than 70 years). Pre-EGD anxiety was measured using the 100-mm visual analog scale (VAS). After EGD, patients were required to complete a questionnaire on pain, nausea, choking, overall discomfort, and quality of the examination either using VAS or answering some questions. The duration of EGD was timed. Blood pressure (BP), oxygen saturation (SpO2), and heart rate (HR) were monitored before, during, and after EGD. Results: There was no statistically significant association with age, gender, baseline VAS, SpO2, BP, HR, and duration of the procedure among all groups. Transnasal EGD was successfully completed in all patients. No severe complication(s) occurred in all groups. Compared to baseline data, systolic BP (SBP), diastolic BP (DBP), and HR gradually rose before endoscopy was initiated, but they decreased 5 minutes after endoscopic insertion. However, the change in SpO2 showed a contrary trend during the whole procedure. There was no statistical significance with the differential value compared to the baseline of DBP, HR, and SpO2 during the different stages between groups A, B, and control. Compared to baseline data, only SBP during following endoscopic insertion and endoscopy in group B increased with statistical significance. On the basis of the patients’ evaluation, no difference was found in intubation pain, overall discomfort, choking, nausea/vomiting, or overtolerance among the three groups. Conclusion: Ultrathin transnasal EGD has good technical performances, has high security and reliability, and is generally well accepted and preferred by geriatric patients.