{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:25:34Z","timestamp":1788449134684,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Adequate pharyngeal observation during esophagogastroduodenoscopy (EGD) is increasingly recognized as an important component of high\u2010quality upper gastrointestinal endoscopy. However, visualization may be impaired by gag reflexes and patient movement. The current study evaluated the association between sedation strategy and successful pharyngeal observation during routine EGD. Further, whether this association differs according to operator experience was examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010center observational study included consecutive sedated EGD procedures performed between April 2024 and March 2025. Successful pharyngeal observation was defined as the successful identification of predefined pharyngeal and hypopharyngeal anatomical landmarks. Multivariate logistic regression analysis was performed to identify factors independently associated with successful pharyngeal observation. Interaction, sensitivity, and propensity score\u2010matched analyses were also conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 444 EGD procedures, including 245 performed under midazolam sedation and 199 under propofol sedation, were analyzed. The propofol group had a significantly higher successful pharyngeal observation rate than the midazolam group (90.0%\u00a0vs. 79.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.011). In the multivariate analysis, propofol sedation was independently associated with successful pharyngeal observation (odds ratio: 2.18, 95% confidence interval: 1.20\u20133.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008). Sensitivity analyses excluding biopsy cases and analyses restricted to trainees yielded consistent results. Propensity score\u2010matched analysis also yielded consistent results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sedation strategy was independently associated with successful pharyngeal observation during routine EGD. Propofol sedation may facilitate a more consistent pharyngeal visualization across operators with varying levels of experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70422","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:59:30Z","timestamp":1788447570000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Propofol Versus Midazolam Sedation With Successful Pharyngeal Observation During Upper Gastrointestinal Endoscopy: A Retrospective Study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5484-8504","authenticated-orcid":false,"given":"Kazuya","family":"Sumi","sequence":"first","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto\u2010Toyosu Hospital  Tokyo Japan"},{"name":"Hitachi Medical Center Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Sato","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto\u2010Toyosu Hospital  Tokyo Japan"},{"name":"Hitachi Medical Center Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4046-0243","authenticated-orcid":false,"given":"Tomona","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto\u2010Toyosu Hospital  Tokyo Japan"},{"name":"Hitachi Medical Center Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6783-3093","authenticated-orcid":false,"given":"Kota","family":"Uehara","sequence":"additional","affiliation":[{"name":"Hitachi Medical Center Hospital Ibaraki Japan"},{"name":"Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Hitachi Medical Center Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9854-4257","authenticated-orcid":false,"given":"Takayoshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto\u2010Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u2010113128"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.10.034"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102018\u2010317111"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101104\u20105245"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2022.062"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010024\u201010903\u20105"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010014\u20104009\u20105"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/den3.447"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13882"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102006\u2010945195"},{"issue":"10","key":"e_1_2_13_12_1","first-page":"18647","article-title":"Propofol Sedation versus no Sedation in Detection of Pharyngeal and Upper Gastrointestinal Superficial Squamous Cell Carcinoma Using Endoscopic Narrow Band Imaging: A Multicenter Prospective Trial","volume":"8","author":"He Y.","year":"2015","journal-title":"International Journal of Clinical and Experimental Medicine"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13788"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.07.072"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001099"},{"issue":"04","key":"e_1_2_13_16_1","first-page":"244","article-title":"Validity and Reliability of the Observer's Assessment of Alertness\/Sedation Scale: Study With Intravenous Midazolam","volume":"10","author":"Chernik D. 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