7127 Can a 3.1 mm stand-alone battery powered esophagoscope (bpe) screen the esophagus for esophagitis and barrett's ? a prospective blinded comparison with a standard videoendoscope (sve).

Intro: There exist several indications (varices, Barrett's, GERD) where an esophagoscopy alone would suffice rather than a complete endoscopy. Feasibility of esophagoscopy using a prototype battery powered flexible fiberoptic esophagoscope (Olympus XEF-DP) with an outer diameter of 3.1 mm has been reported (GI Endo 1999;49: AB157). Aim: In a prospective blinded study, compare esophageal visualization between the BPE & the SVE. Methods: 95 consecutive pts. underwent sedated esophagoscopy with the BPE foll. by SVE, done by 2 endoscopists, each blinded to the findings of the other. On a visual analogue scale, the 2 endoscopists rated pt. tolerance & instrument performance. Results: 89 (M 57) pts. (mean age 56 yr.) were analyzed. Mean duration of esophagoscopy was 4.4 mins (range 2-10). Sensitivity : specificity (%) with BPE was 94 : 96 (Barrett's) & 87 : 94 (all lesions). Measures of pt. tolerance were (BPE : SVE, p value): intubation ease 96 : 93, 0.06; gagging 98 : 91, 0.0012; coughing 98 : 96, 0.08; belching 89 : 92, 0.02 (higher scores indicate better rating). Measures of scope performance were (BPE : SEV, p value): visibility 90 : 98, 0.0001; air insufflation 92 : 98, 0.001; maneuverability 87 : 99, 0.001. Concl: The esophagus can be accurately visualized in under 5 min with the BPE. Inter-observer variability may account for some of the disagreements. Being a standalone instrument, not needing a light source, processor or a monitor, it could facilitate esophagoscopy outside of the conventional GI lab setting. Its tolerance unsedated, use transnasally & potential in a true screening environment are being studied.