INTRODUCTION Unsedated peroral endoscopy, including ultrathin endoscopy (UE) and conventional endoscopy (CE), is feasible in clinical practice but requires improved endoscopic operability and patient tolerance. Currently, the impact of the breathing method on these factors remains unclear. We conducted the first randomized controlled trial comparing oral breathing (OB) and nasal breathing (NB) during both UE and CE to assess their influence. METHODS About 252 eligible patients undergoing CE or UE were randomly assigned to OB or NB groups. Endoscopists and patients rated endoscopic operability and patient tolerance using a 100-mm visual analog scale. Visibility from the oral cavity to the middle pharynx was recorded. RESULTS OB led to a higher rate of improved visibility from the oral cavity to the middle pharynx compared with NB, ranging from 79.3% to 81.0%. Multivariate correlation analyses showed significantly lower visual analog scale scores for endoscopic operability with OB compared with NB in both UE and CE groups ( P < 0.05). No significant differences were found in the overall evaluation of patient tolerance between OB and NB groups in UE and CE, whereas the smaller diameter of UE exhibited better patient tolerance compared with CE. Discriminant analysis comparing endoscope types and breathing methods revealed that UE with OB outperformed other combinations in the overall evaluation of endoscopic operability and patient tolerance ( P < 0.05). DISCUSSION OB facilitates endoscopic operability compared with NB in peroral endoscopy. UE with OB is recommended as the preferred choice for unsedated peroral endoscopy in daily practice.

中文翻译：

---

经口内窥镜检查中，与鼻呼吸相比，经口呼吸有利于内窥镜操作：一项随机对照试验。


引言非镇静经口内窥镜检查，包括超薄内窥镜检查（UE）和传统内窥镜检查（CE），在临床实践中是可行的，但需要提高内窥镜操作性和患者耐受性。目前，呼吸方法对这些因素的影响尚不清楚。我们进行了第一个随机对照试验，比较 UE 和 CE 期间的口呼吸 (OB) 和鼻呼吸 (NB)，以评估它们的影响。方法 大约 252 名符合条件的接受 CE 或 UE 的患者被随机分配到 OB 组或 NB 组。内窥镜医师和患者使用 100 毫米视觉模拟标度评估内窥镜可操作性和患者耐受性。记录从口腔到中咽部的可见度。结果 与 NB 相比，OB 导致从口腔到中咽部的可视性改善率更高，范围为 79.3% 至 81.0%。多变量相关分析显示，在 UE 和 CE 组中，与 NB 相比，OB 内窥镜可操作性的视觉模拟量表评分显着较低 ( P < 0.05)。 UE和CE中OB组和NB组患者耐受性的总体评价没有发现显着差异，而较小直径的UE与CE相比表现出更好的患者耐受性。比较内窥镜类型和呼吸方法的判别分析表明，在内窥镜可操作性和患者耐受性的总体评估中，UE 与 OB 的表现优于其他组合（P < 0.05）。讨论 与经口内窥镜检查中的 NB 相比，OB 有助于内窥镜操作。建议将 UE 联合 OB 作为日常实践中非镇静经口内窥镜检查的首选。