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conferenceseries
.com
Volume 7, Issue 3 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Gastro 2017
June 12-13, 2017
June 12-13, 2017 Rome, Italy
11
th
Global
GastroenterologistsMeeting
Observation of the pharynx to the cervical esophagus using transnasal endoscopy with image enhanced
endoscopy
Kenro Kawada
Tokyo Medical and Dental University, Japan
T
he more progress achieved in endoscopy, the more superficial cancers in the head and neck regions associated with esophageal
squamous cell carcinoma have been found. Between August 1996 and March 2017, we have been experienced 350 cases of
superficial head and neck cancers. Some areas difficult to observe with trans-oral endoscopy because of gag reflex. We applied new
trans-nasal esophagogastroduodenoscopy (EGD) with image enhanced endoscopy (narrow band imaging, blue laser imaging, and
linked color imaging) and modifications of endoscopic techniques for observing head and neck cancers and obtaining excellent
results. The patient was asked to bow their head deeply in the left lateral position, and then we kept our hand on the back of the
patient’s head and pushed it forward by one span of our hand. Then, he was asked to lift up their chin as far as possible. After the
local anesthesia of the nose without sedation, the endoscope was inserted through the nose. When inspecting the hypopharynx and
the orifice of the esophagus, we asked the patient to blow hard and puff his cheeks with his mouth closed. This procedure provided a
much better view of the orifice of the esophagus than had been possible with trans-oral endoscopy. Furthermore, observing the base
of the tongue using trans-oral endoscopy is also difficult. When inspecting the oropharynx, the patient opens their mouth wide and
sticks their tongue out as far as possible while making a vocal sound similar to a long I. The endoscopist then forces the transnasal-
endoscope to make a U-turn, and observes the oropharynx, in particular the base of the tongue. Mucosal redness, a pale thickened
mucosa, white deposits, or loss of a normal vascular pattern, as well as demarcated brownish areas with image enhanced endoscopy,
are important characteristics to diagnose superficial carcinoma.
Biography
Kenro Kawada completed his Graduation in 1995 at Tokyo Medical and Dental University. He worked at Medical Hospital, Tokyo Medical and Dental University in
1995 and 2001. He was Junior Associate Professor in Department of Gastrointestinal Surgery at Tokyo Medical and Dental University in 2008.
kawada.srg1@tmd.ac.jpKenro Kawada, J Gastrointest Dig Syst 2017, 7:3(Suppl)
DOI: 10.4172/2161-069X-C1-049