Introduction of Transnasal Endoscopy in Institutional Mass Surveys (Evaluation of Hemodynamics During the Procedure)

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  • HAYASHI Toru
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • TORISU Ryusuke
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • NOMURA Masahiro
    Faculty of Integrated Arts and Sciences, University of Tokushima
  • YASUDA Mitsugi
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • KITAMURA Shinji
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • AOKI Rika
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • KAGOSHIMA Akira
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • INOUE Hiroyuki
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • YAMANOI Akira
    Department of Medicine, Kagawa Prefectural Cancer Detection Center
  • ITO Susumu
    Department of Digestive and Cardiovascular Medicine, University of Tokushima

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Other Title
  • 施設検診への経鼻内視鏡検査の導入(検査時の循環動態の検討)
  • シセツ ケンシン エノ ケイビ ナイシキョウ ケンサ ノ ドウニュウ ケンサジ ノ ジュンカン ドウタイ ノ ケントウ

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Abstract

To confirm the effectiveness of institutional endoscopic mass surveys, we compared the rate of gastric cancer detected by endoscopic examination with that detected by gastric radiography. We investigated the possibility of introducing transnasal endoscopy in institutional endoscopic mass surveys with respect to various problems, including tolerability and accidental complications. The detection rate of cancer, the positive predictive value, the percentage of early cancers and the rate of EMR/early gastric cancers detected by endoscopic mass survey were higher than those detected by direct or indirect radiography. We analyzed the frequency domain of heart rate variability and blood pressure to investigate the autonomic nervous function during endoscopy. The variation of HF power and that of the LF/HF ratio in transnasal endoscopy were less than in conventional or small-caliber peroral endoscopy. Premedication by nasal spray with lidocaine hydrochloride and epinephrine resulted in the persistent elevation of blood pressure.<BR>In conclusion, transnasal endoscopy results in reduced discomfort and reduced variation of autonomic nervous function during the procedure, and is suitable for use in institutional mass surveys, especially for patients showing a severe vomiting reflex or cardiovascular complications.

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