"However, given the relative rarity of esophageal cancer compared with the high prevalence of GERD," Jobe explained. "Routine screening within the general population using traditional upper endoscopy would be too costly."

Eager to find an economically viable means of screening and monitoring this patient population, Jobe and colleagues endeavored to devise a method that would reduce the cost, inconvenience and complications associated with sedated endoscopy and they succeeded.

"This trial has established that unsedated small-caliber endoscopy used in an office setting is technically feasible, well-tolerated and accurate in the screening and diagnosis of Barrett's esophagus. It's a more personal approach and represents the potential to eliminate the infrastructure and costs required for intravenous sedation. It's also more immediate. As soon as you're done, you can tell the patient what you've found."

To perform a sedated upper endoscopy, an endoscope, 9.8 mm in diameter, is passed through the mouth and throat to the esophagus, stomach and small intestine. The procedure requires the resources and infrastructure of an outpatient procedure unit, two assistants, intravenous sedation and post-procedure monitoring, with a total cost in the thousands of dollars. And, as with any procedure for which the patient is sedated, the risk of complications, though rare, is higher.

By comparison, the skinny scope procedure is performed by a single clinician in an office setting and does not require sedation. Patients inhale a topical anesthetic that numbs their nasal passages and throat. The clinician then passes a smaller-caliber endoscope, 4.9 mm in diameter, through the nose, pharynx and throat. Th
'"/>

Contact: Tamara Hargens
hargenst@ohsu.edu
503-494-8231
Oregon Health & Science University
4-Dec-2006