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Unsedated Small-Caliber Endoscopy Effective

Office procedure detects Barrett's esophagus with lower cost and risk than sedated endoscopy

TUESDAY, Dec. 12 (HealthDay News) -- When it comes to screening patients with symptoms of gastroesophageal reflux disease for Barrett's esophagus, an office-based unsedated small-caliber endoscopy procedure is comparable to conventional sedated endoscopy, researchers report in the December issue of the American Journal of Gastroenterology.

Blair A. Jobe, M.D., of the Oregon Health & Science University Digestive Health Center in Portland, and colleagues studied 274 patients scheduled for endoscopic screening, 121 of whom underwent unsedated small-caliber endoscopy and conventional endoscopy in a crossover study.

The researchers found that the prevalence of Barrett's esophagus was 26 percent for conventional endoscopy and 30 percent for unsedated endoscopy with a "moderate" level of agreement between the two approaches. Each technique detected four cases of low-grade dysplasia, although only one case was picked up by both techniques. The investigators also found that tissue samples collected with unsedated endoscopy were smaller than with conventional endoscopy and that 71 percent of patients would prefer unsedated small-caliber endoscopy in the future.

"This approach represents the potential to avoid the infrastructure and cost required for intravenous sedation," the authors conclude. However, "a study with a larger number of patients with dysplasia will be required to definitively establish in-office unsedated endoscopy as equivalent to the conventional approach in Barrett's esophagus surveillance."

The study was funded by the U.S. National Institutes of Health.

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