Sedation-free esophageal procedure decreases health risks
8:48 a.m. Monday, January 8, 2007
52-year-old Nick Tsaclas is getting ready for his annual test for cancer of the esophagus. Nine years ago, he was diagnosed with Barrett's Esophagus, a potentially pre-cancerous condition.
"I was relieved to know that it was not actually -- it had not progressed to the point where it was something to worry about," Tsaclas said.
Esophageal cancer responds well when caught early. Doctors look for it using a thin flexible tube down the esophagus. They can get there through the mouth or through the nose.
"The gag reflex is in the mouth. So to avoid the gag reflex, one has to either sedate the patient or physically go behind the gag reflex," said Dr. Jonathan Aviv.
Related links
For more information on esophageal cancer, log on to the following Web sites:
Cancer.org
American College of Gastroenterology
National Cancer Institute
The traditional exam is done through the mouth in a surgical suite with the patient under anesthesia.
"Almost all the complications related to upper gi endoscopy are not because of the procedure itself, but because of the intravenous sedation that's used," Aviv said.
But during Tsaclas' screening, he's sitting up and fully awake the whole time.
"You don't need those risks to see what's going on," Aviv said.
After numbing his nose, the doctor does an in-office procedure called trans-nasal esophagoscopy or TNE.
The exam takes five minutes, and the doctor removes a small bit of tissue for biopsy.
"It's not uncomfortable. It really isn't," Tsaclas said.
After the test, Aviv shows his patient what he saw and gives him a written report.
"Everything is normal here," Aviv said.
Best of all, Tsaclas is on his way quickly because he doesn't have to wait for anesthesia to wear off.
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