Ultrathin endoscope flexibility can predict discomfort associated with unsedated transnasal esophagogastroduodenoscopy

Table 1 Profiles of six endoscopes and outcomes for transnasal insertion

	A	B	C	D	E	F
EFI (mm)	224	192.4	175.2	174.8	146	166.6
Tip diameter (mm)	5	5.4	5.9	5.9	5.2	5.4
Transnasal insertion
Insertion success rate	58/59	110/112	119/123	112/118	47/47	57/57
Nasal bleeding rate	0/58	2/110	2/119	2/112	1/47	0/57
VAS	4.2 ± 2.7	4.0 ± 2.1	4.0 ± 2.4	4.0 ± 2.3	3.2 ± 2.2	3.8 ± 2.3
Examination time (s)	351.0 ± 58.8	345.8 ± 62.2	324.9 ± 61.1	340.0 ± 48.1	376.7 ± 61.7	349.1 ± 57.3

VAS: Visual analog scale; EFI: Endoscopic flexibility index.

Table 2 Characteristics of patients

	Transnasal insertion(n = 503)	Transoral insertion(n = 235)	P value
Gender M/F	299/204	118/117	< 0.05
Age (yr)	56.8 ± 11.2 (25-84)	61.3 ± 13.0 (27-88)	< 0.05
1st examination Y/N	54/449	19/216	0.29
Operator A/B	326/177	143/92	0.32
Endoscope			0.36
A	58	31
B	110	52
C	119	58
D	112	61
E	47	17
F	57	16
Examination time (s)	343.4 ± 59.4 (210-630)	324.5 ± 59.8 (196-600)	< 0.05
VAS	3.9 ± 2.3 (0-10)	4.1 ± 2.5 (0-10)	0.90

VAS: Visual analog scale; M: Male; F: Female.

Table 3 Multivariate analysis for visual analog scale in transnasal insertion

	Parameter estimate ± SE	P value
Gender (F)	0.780 ± 0.100	< 0.05
Age	-0.0193 ± 0.00886	< 0.05
1st examination (N)	0.252 ± 0.160	0.12
Operator (A)	-0.341 ± 0.110	< 0.05
Scope (E)	-0.719 ± 0.281	< 0.05
Examination time	0.00270 ± 0.00180	0.134

Table 4 Results of multivariate analysis of visual analog scale scores for transoral insertion

	Parameter estimate ± SE	P value
Gender (F)	0.575 ± 0.156	< 0.05
Age	-0.0343 ± 0.0125	< 0.05
1st examination (N)	-0.00289 ± 0.294	0.99
Operator (A)	-0.297 ± 0.177	0.10
Scope (C)	0.634 ± 0.313	< 0.05
Examination time	-0.00159 ± 0.00291	0.59

Table 5 Parameters of endoscopic flexibility index and tip diameter by multivariate analysis for visual analog scale

	Transnasal insertion	Transoral insertion
EFI	0.0125 ± 0.00563 (P < 0.05)	0.0212 ± 0.00966 (P < 0.05)
Tip diameter	0.450 ± 0.338 (P = 0.18)	1.33 ± 0.561 (P < 0.05)

EFI: Endoscopic flexibility index.