{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:31:01Z","timestamp":1783981861442,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T00:00:00Z","timestamp":1703030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPGN rep."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Unsedated transnasal endoscopy (TNE) as transnasal esophagoscopy (TN\u2010Eso) has emerged as a promising alternative to esophagogastroduodenoscopy (EGD) under sedation to assess eosinophilic esophagitis (EoE). We report our center's experience using single\u2010use gastroscopes to perform sedation\u2010free transnasal EGD (TN\u2010EGD) with biopsies in an office\u2010based setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed on patients with eosinophilic esophagitis who underwent office\u2010based sedation\u2010free TNE with topical analgesia and virtual reality (VR) procedural dissociation and distraction. A sterile, single\u2010use, ultra\u2010slim 3.5\u2009mm outer diameter, 110\u2009cm long gastroscope with 2\u2009mm working channel (EvoEndo) was used to perform TNE with biopsies\/brushings. Data including demographics, procedure success rate, total visit time, biopsy adequacy, procedure time, procedural preference, and complications were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Office\u2010based TNE was completed in 8 patients (six males, age range 11\u201320 years). The endoscope was advanced by an experienced transoral endoscopist successfully through the nares into stomach (transnasal esophagogastroscopy [TN\u2010EG]) in all subjects (100%) and into the duodenum (TN\u2010EGD) in seven subjects (87.5%). Biopsies were obtained from esophagus in all cases and from the stomach\/duodenum in five cases. Histological assessment, esophageal brushing, disaccharidase enzyme analysis, or duodenal aspirate analysis were performed as indicated. EoE reevaluation was the primary indication to perform endoscopy in all patients. Visual and histologic findings were all adequate for assessment. There were no significant adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Office\u2010based TN\u2010EGD with VR procedural distraction and dissociation using single\u2010use gastroscopes was effective to monitor EoE, gastritis, and duodenitis in a pediatric practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpr3.12025","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T12:07:55Z","timestamp":1703074075000},"page":"29-34","source":"Crossref","is-referenced-by-count":8,"title":["Office\u2010based sedation\u2010free transnasal esophagogastroduodenoscopy with biopsies using single\u2010use gastroscopes: A pediatric single\u2010center experience"],"prefix":"10.1002","volume":"5","author":[{"given":"Yamen","family":"Smadi","sequence":"first","affiliation":[{"name":"Eosinophilic Esophagitis Center Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessina","family":"Thomas","sequence":"additional","affiliation":[{"name":"Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Bittar","sequence":"additional","affiliation":[{"name":"Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Norton","sequence":"additional","affiliation":[{"name":"Nurse Care Coordinator, Eosinophilic Esophagitis Center Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel A.","family":"Friedlander","sequence":"additional","affiliation":[{"name":"EvoEndo, Inc. Centennial Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children, Orlando Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,20]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.giec.2022.10.006","article-title":"Pediatric unsedated transnasal endoscopy","volume":"33","author":"Venkatesh RD","year":"2023","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/den.12612","article-title":"Current status of transnasal endoscopy worldwide using ultrathin videoscope for upper gastrointestinal tract","volume":"28","author":"Tanuma T","year":"2016","journal-title":"Digest 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JA","year":"2021","journal-title":"J Aller Clin Immunol Pract"},{"issue":"3","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-057892","article-title":"Virtual reality\u2010based distraction for intravenous insertion\u2010related distress in children: a study protocol for a randomised controlled trial","volume":"12","author":"Ali S","year":"2022","journal-title":"BMJ Open"},{"issue":"2","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1067\/mge.2003.59","article-title":"Unsedated transnasal EGD in daily practice: results with 1100 consecutive patients","volume":"57","author":"Dumortier J","year":"2003","journal-title":"Gastrointest Endosc"},{"issue":"5","key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.gie.2015.07.016","article-title":"Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract: systematic review and meta\u2010analysis","volume":"82","author":"Sami SS","year":"2015","journal-title":"Gastrointest Endosc"},{"issue":"6","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1097\/MPG.0000000000001038","article-title":"Adverse events following gastrointestinal endoscopy in children: classifications, characterizations, and implications","volume":"62","author":"Kramer RE","year":"2016","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"12","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/dote\/doy056","article-title":"Blind esophageal brushing offers a safe and accurate method to monitor inflammation in children and young adults with eosinophilic esophagitis","volume":"31","author":"Smadi Y","year":"2018","journal-title":"Dis Esophagus"},{"issue":"2","key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.gie.2006.03.015","article-title":"Complications of pediatric EGD: a 4\u2010year experience in PEDS\u2010CORI","volume":"65","author":"Thakkar K","year":"2007","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.4097\/kja.d.18.00165","article-title":"Does pediatric anesthesia cause brain damage?\u2014addressing parental and provider concerns in light of compelling animal studies and seemingly ambivalent human data","volume":"71","author":"Lee JR","year":"2018","journal-title":"Korean J Anesthesiol"}],"container-title":["JPGN 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