152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

(Düsseldorf) cited the development of ultrathin
gastroscopes that now permit transnasal
gastroscopy (figure 1). “Unlike in France,”
H. Neuhaus said, “this method, which enjoys
high patient acceptance, has yet to become
established in Germany.”
An objection to transnasal endoscopy has been
that the resolution is inferior to that provided
by conventional endoscopes. According to
H. Neuhaus, however, the resolution is no longer
a problem with the newer units. Because of
the small navigation mechanism, the ultrathin
endoscopes have the advantage of being able
to inspect directly behind mucosal folds – an
Fig. 2
H. Neuhaus
I Chromoendoscopy: Methylene blue staining of Barrett’s metaplasia
(H. Neuhaus, Düsseldorf)
Congress Short Report Falk Symposium 152
important capability, such as in the search for
esophageal carcinomas. Potential indications for
the new method, H. Neuhaus said, would include
diagnostic esophagogastroduodenoscopy
(EGD) without sedation, screening for Barrett’s
esophagus, dysphagia work-up, transnasal tube
placement and passage of high-grade stenoses
in the proximal gastrointestinal tract.
Chromoendoscopy: better
evaluation of lesions
Another example of progress is the method of
chromoendoscopy (figure 2), which, because of
the color technology, enables a better evaluation
of lesions. “In particular, lesions are much better
demarcated,” H. Neuhaus explained. One method
that has not gained broad acceptance is the
technique of zoom endoscopy, which, despite
its capabilities for magnification, does not offer
any advantages over conventional methods. In
the general, the reliability of findings returned
by endoscopic examinations depends to a great
degree on the quality of patient preparation and
the examination technique. The exact clinical
utility of further increases in resolution is difficult
to assess, but would seem helpful.
5