Endoscopic Yield, Appropriateness, and Complications of Pediatric Upper Gastrointestinal Endoscopy in an Adult Suite: A Retrospective Study of 822 Children
3
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopyperformed by adult gastroenterologists in an adult endoscopic suite. Methods: This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelinesby American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology andNutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy. Results: Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157(19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94(11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%)and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopicyield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%),dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children. Conclusions: Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation witha pediatrician.
Abstract
Background/Aims: This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopyperformed by adult gastroenterologists in an adult endoscopic suite. Methods: This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelinesby American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology andNutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy. Results: Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157(19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94(11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%)and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopicyield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%),dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children. Conclusions: Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation witha pediatrician.
참고문헌 (22)
- Freeman NV, "Clinical evaluation of the fiberoptic bronchoscope(Olympus BF 5B)for pediatric endoscopy", J Pediatr Surg, 8, pp.213~220 (1973)
- Ament ME, "Upper gastrointestinal fiberoptic endoscopy in pediatric patients", Gastroenterology, 72, pp.1244~1248 (1977)
- Gleason WA Jr, "Fiberoptic gastrointestinal endoscopy in infants and children", J Pediatr, 85, pp.810~813 (1974)
- Rothbaum RJ, "Complications of pediatric endoscopy", Gastrointest Endosc Clin N Am, 6, pp.445~459 (1996)
- Dar AQ, "Anesthesia and sedation in pediatric gastrointestinal endoscopic procedures : a review", World J Gastrointest Endosc, 2, pp.257~262 (2010)
- Squires RH Jr, "Indications for pediatric gastrointestinal endoscopy : a medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition", J Pediatr Gastroenterol Nutr, 23, pp.107~110 (1996)
- Franciosi JP, "Changing indications for upper endoscopy in children during a 20-year period", J Pediatr Gastroenterol Nutr, 51, pp.443~447 (2010)
- ASGE Standards of Practice Committee, "Modifications in endoscopic practice for pediatric patients", Gastrointest Endosc, 79, pp.699~710 (2014)
- Hassall E, "Requirements for training to ensure competence of endoscopists performing invasive procedures in children. Training and Education Committee of the North American Society for Pediatric Gastroenterology and Nutrition(NASPGN), the Ad Hoc Pediatric Committee of American Society for Gastrointestinal Endoscopy(ASGE), and the executive council of NASPGN", J Pediatr Gastroenterol Nutr, 24, pp.345~347 (1997)
- Lee WS, "Appropriateness, endoscopic findings and contributive yield of pediatric gastrointestinal endoscopy", World J Gastroenterol, 19, pp.9077~9083 (2013)
- Jantchou P, "Appropriateness of upper gastrointestinal endoscopy in children : a retrospective study", J Pediatr Gastroenterol Nutr, 44, pp.440~445 (2007)
- Miele E, "Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children", Aliment Pharmacol Ther, 32, pp.582~590 (2010)
- Guariso G, "Indications to upper gastrointestinal endoscopy in children with dyspepsia", J Pediatr Gastroenterol Nutr, 50, pp.493~499 (2010)
- Sheiko MA, "Diagnostic yield of EGD in children : a retrospective single-center study of 1000 cases", Gastrointest Endosc, 78, pp.47~54 (2013)
- Sabir OME, "Upper gastrointestinal endoscopy in Sudanese infants and children", Sudan Journal of Medical Sciences, 2, pp.91~94 (2007)
- Joshi MR, "Upper GI endoscopy in children-in an adult suite", Kathmandu Univ Med J(KUMJ), 3, pp.111~114 (2005)
- Hayat JO, "Paediatric endoscopy performed by adult-service gastroenterologists", Eur J Gastroenterol Hepatol, 20, pp.648~652 (2008)
- Khuroo MS, "Hepatobiliary and pancreatic ascariasis", World J Gastroenterol, 22, pp.7507~7517 (2016)
- Gonvers JJ, "Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy unit", Endoscopy, 28, pp.661~666 (1996)
- Seematter-Bagnoud L, "Overuse and underuse of diagnostic upper gastrointestinal endoscopy in various clinical settings", Int J Qual Health Care, 11, pp.301~308 (1999)
- Alatise OI, "Paediatric endoscopy by adult gastroenterologists in Ile-Ife, Nigeria : a viable option to increase the access to paediatric endoscopy in low resource countries", Afr J Paediatr Surg, 12, pp.261~265 (2015)
- Thakkar K, "Complications of pediatric EGD : a 4-year experience in PEDS-CORI", Gastrointest Endosc, 65, pp.213~221 (2007)
