{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:06:51Z","timestamp":1791288411684,"version":"4.3.0"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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":["JPGN rep."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although sedation\u2010free transnasal endoscopy (TNE) is conventionally performed in an upright seated position in pediatric patients, emerging data suggest that the left lateral decubitus (LLD) position may improve both endoscopic visualization and patient comfort and safety. This study compared TNE outcomes and tolerance in pediatric patients using the upright versus LLD position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted on 110 pediatric patients who underwent sedation\u2010free TNE from September 2024 to November 2025. Three cases were excluded for scope failure during the procedure. Data including patient demographics, procedure time, TNEase (patient tolerance) score, and adverse events were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 107 cases, 71 were performed upright, 31 LLD, and 5 converted from upright to LLD due to syncope. Four cases of emesis and two cases of minor epistaxis occurred during upright TNE, while no major adverse events occurred during LLD TNE. There were no significant differences between upright and LLD TNE in patient age (upright 13.8\u2009\u00b1\u20092.8 vs. LLD 12.5\u2009\u00b1\u20093.3 years), mean TNEase score (1.1 vs. 1.4), or procedure times. For TNE\u2010esophagoscopy, mean procedure times were 5.1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955) and 5.5\u2009min (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) in the upright versus LLD position, respectively. Times were 6.1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) versus 6.8\u2009min (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) for TNE\u2010esophagogastroscopy, and 17.7 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) versus 17.4\u2009min (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) for TNE\u2010esophagogastroduodenoscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The LLD position is a safe and effective alternative to upright TNE and is better tolerated in patients with orthostatic intolerance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpr3.70248","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:49:58Z","timestamp":1791287398000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A comparison of the upright seated versus left lateral decubitus position during pediatric sedation\u2010free transnasal endoscopy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7716-9084","authenticated-orcid":false,"given":"Catherine","family":"Nguyen","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2072-1735","authenticated-orcid":false,"given":"Molly","family":"Mackensen","sequence":"additional","affiliation":[{"name":"Children's Hospital of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Branen","sequence":"additional","affiliation":[{"name":"Children's Hospital of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0570-8380","authenticated-orcid":false,"given":"Katherine","family":"Vaidy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition Medical College of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition Medical College of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"2","key":"e_1_2_9_2_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_9_3_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.5946\/ce.2024.339","article-title":"How to improve the quality of upper gastrointestinal diagnostic endoscopy?","volume":"58","author":"Dinis\u2010Ribeiro M","year":"2025","journal-title":"Clin Endosc"},{"issue":"4","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1097\/MPG.0000000000002277","article-title":"Pediatric endoscopy and high\u2010risk patients: A clinical report from the NASPGHAN Endoscopy 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conventional EGD","volume":"35","author":"Preiss C","year":"2003","journal-title":"Endoscopy"},{"issue":"12","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1016\/j.cgh.2019.01.023","article-title":"Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles","volume":"17","author":"Nguyen N","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2023.1267148","article-title":"A guide on transnasal endoscopy: setting up a pediatric unsedated endoscopy program","volume":"11","author":"Friedlander JA","year":"2023","journal-title":"Front Pediatr"},{"issue":"3","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0016-5107(94)70068-0","article-title":"Unsedated trans\u2010nasal pharyngoesophagogastroduodenoscopy (T\u2010EGD): technique","volume":"40","author":"Shaker R","year":"1994","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"e_1_2_9_11_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"},{"issue":"4","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1136\/flgastro-2015-100589","article-title":"Transnasal endoscopy: no gagging no panic!","volume":"7","author":"Parker C","year":"2016","journal-title":"Frontline Gastroenterol"},{"issue":"3","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/jpr3.70047","article-title":"Left lateral decubitus position during sedation\u2010free transnasal endoscopy: a pilot study","volume":"6","author":"Lee R","year":"2025","journal-title":"JPGN Reports"},{"issue":"2","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1002\/jpn3.12102","article-title":"Transnasal endoscopy ease score \u201cTNEase score\u201d to evaluate patient tolerance of unsedated transnasal endoscopy","volume":"78","author":"Nguyen N","year":"2024","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["JPGN 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