Prospective randomized comparative study of hemodynamic changes between ultrathin transnasal and conventional transoral esophagogastroduodenoscopy in percutaneous endoscopic gastrostomy placement with modified introducer method under sedation.

AIM: Percutaneous Endoscopic Gastrostomy (PEG) placement is a useful but invasive method. Recently, the hemodynamic change of ultrathin transnasal esophagogastroduodenoscopy (transnasal EGD) was reported as less than that of conventional transoral EGD (transoral EGD). This study compared hemodynamic changes between transnasal EGD and transoral EGD in the setting of PEG placement using a modified Introducer method under sedation.

METHODS: All 25 patients who were performed PEG in our hospital during the period December 2007 to February 2009 were enrolled in this study. We assigned them randomly to one of two groups, Group A for transoral EGD and Group B transnasal EGD. For both groups, the modified Introducer method was used. Vital signs (systolic blood pressure; SBP, heart rate; HR and rate pressure product; RPP) were monitored before and after scope insertion.

RESULTS: We assigned 13 patients to Group A and 12 patients to Group B. The mean age was 69.4 years old in Group A and 69.8 in Group B. After scope insertion, mean changes of vital signs in Group A and B were, respectively, 17.8 mmHg and 17.3 mmHg in SBP, 12.1 bpm and 5.08 bpm in HR, and 25.9 and 17.5 in RPP.

CONCLUSION: No significant differences of hemodynamic changes were seen between transnasal EGD and transoral EGD for the PEG placement with modified Introducer method under sedation. Results show that both methods are tolerable and feasible for PEG placement.