Oral

Introduction
Transnasal endoscopy (TNE) was first proposed in the 1990s and was applied to patients with gastroenterology problems. TNE was safe and was proven to lower the need for intravenous anesthesia as well as the cost of the exams compared to conventional esophagogastroduodenoscopy (EGD) in adult groups. Consequently, TNE was widely applied to adults with dysphagia, GERD, epigastralgia and even gastric cancer. In contrast, there were few results of the utilization of TNE in pediatric patients.

Objectives
The objective of this study is to evaluate the benefits of TNE in adolescents compared to conventional EGD and the percentage of adverse effects in these two groups.

Methods
We reviewed the pediatric patients from 2012 to 2022, who had undergone TNE in National Taiwan University Hospital due to epigastralgia or routine survey of esophageal varices. Age and gender-matched cohort groups, who had undergone conventional EGD, were recruited at the same time. The continuous and categorical variables were analyzed by student's t test and Fisher's exact test respectively.

Results and Conclusion
From 2012 to 2022, 10 patients, aged between 14 to 20 years old, had undergone TNE resulting from epigastralgia or routine survey of esophageal varices. Another 70 patients were enrolled in the age and gender-matched control group. The percentage of the need for intravenous anesthesia (10% vs 47%), the total exam time (7.55 vs 10.00 min) and the cost of endoscopy (61.00 vs 98.76 USD) were significantly lower in the group of TNE. There was no difference in the percentage of the need for hospitalization, dizziness, epistaxis, nausea and vomiting between these two groups (P>0.05).
TNE is a cost-effective exam and it also reduces the exposure to intravenous anesthesia as well as the exam time, making it a good alteative choice for the adolescents who are scheduled to undergo EGD.