Nationwide survey of pediatric gastrointestinal endoscopy in Japan

Kudo, Toshifumi; Abukawa, Daiki; Nakayama, Yoshiko; Segawa, Osamu; Uchida, Keiichi; Jimbo, Keisuke; Shimizu, Toshiaki

doi:10.1111/jgh.15297

Cited by 10 publications

(7 citation statements)

References 30 publications

(33 reference statements)

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“…This is due to their easy accessibility, low complication rate and rise in recognition of paediatric gastroenterology as a speciality [ 3 ]. In a study conducted in Japan, the number of institutes showing paediatric gastrointestinal endoscopy use was 4.6 times higher than that stated in the previous reports, and the number of paediatric gastrointestinal endoscopies performed was five times higher [ 4 ]. However, the rate of adverse events was also higher than that previously reported [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a study conducted in Japan, the number of institutes showing paediatric gastrointestinal endoscopy use was 4.6 times higher than that stated in the previous reports, and the number of paediatric gastrointestinal endoscopies performed was five times higher [ 4 ]. However, the rate of adverse events was also higher than that previously reported [ 4 ]. In addition, there has been growing concern about the appropriateness and cost-effectiveness of these procedures [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The utility and safety of paediatric endoscopy in a district general hospital in Southeast England

et al. 2022

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This study was done to evaluate the appropriateness, diagnostic yield, and quality of paediatric gastrointestinal endoscopy in a large DGH with tertiary paediatric gastroenterology services. It was a retrospective cohort study of children who had at least one gastrointestinal endoscopy during 31 months (May 2018-Dec 2020) in a district general hospital in Southeast England. The participants were children (2–17 years). Two hundred ninety-three procedures were performed in total, 80% were diagnostic and 20% for surveillance. The median age was 12 years and 52.5% were males. Oesophago-gastro-duodenoscopy (OGD) corresponded to 79.5% of procedures, ileo-colonoscopy (IC) to 7.2% and the remaining had both procedures. The main diagnostic indication was persistent abdominal pain in 33.5% of cases, followed by suspected GORD (14.8%), recurrent vomiting (14.3%), dysphagia (9.1%) and blood loss per rectum (8.6%). A total of 64.7% showed abnormal macroscopic findings, and 69.2% showed histopathological signs of disease. The most common histological diagnosis was gastritis in 23% followed by coeliac disease in 13%, reflux oesophagitis in 12.2% and inflammatory bowel disease in 9.6%. Procedures were performed with utmost safety with two reported cases of complications, which were appropriately managed. The completion rate of diagnostic IC was 87%. A waiting time of 6 weeks was achieved in 50.4% of cases. Conclusion : Paediatric endoscopy can be safely performed in a district general hospital with the right setup and can aid in the management of gastrointestinal disease in the paediatric patient. It is important to monitor and regularly audit such practices to improve the quality of specialist services. What is Known: • Paediatric endoscopy is predominantly performed in large tertiary centres and included in the diagnostic algorithm for many paediatric gastrointestinal conditions. • There are recommendations on clinical indication endorsed by ESPGHAN and key quality indicators published jointly by JAG and BSPGHAN . What is New: • Paediatric endoscopy can be appropriately and safely performed in district general hospital by trained professionals, decreasing the workload in larger tertiary paediatric centres. • Adoption of regular audit practices is essential to ensure and improve quality and appropriateness of this specialist service.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The utility and safety of paediatric endoscopy in a district general hospital in Southeast England

et al. 2022

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“…Some diseases of the digestive tract cannot be diagnosed by clinical methods alone, and need to be diagnosed by gastrointestinal endoscopy. At present, digestive endoscopy has been widely used in diagnosis and treatment of children with celiac disease, esophageal stricture, eosinophilic esophagitis, inflammatory bowel disease, congenital muscular hypertrophy and lymphoma, congenital small intestinal lymphangiectasia, polyposis disease, congenital hypertrophic pyloric stenosis, and Hirschsprung's disease (39). The respiratory and circulatory systems are the main sites of AEs in children after GI endoscopy, including fluctuations in heart rate and blood pressure, arrhythmia, myocardial ischemia, respiratory depression, hypoxemia, pulmonary edema, and aspiration (40).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the incidence rates of adverse events after digestive endoscopy in children

Meng¹,

Fan²,

Zhang³

et al. 2022

Transl Pediatr

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Background: With the widespread use of digestive endoscopy in children, a variety of adverse events (AEs) have occurred after digestive endoscopy. However, there are notable differences in the incidence of adverse reactions in digestive endoscopy in children at present, which makes it difficult to assess the safety of digestive endoscopy in children. Methods: Studies related to digestive endoscopy in children were screened from January 2005 to October 2021 from PubMed, Web of Science, Spring, CNKI, and Science Direct databases. RevMan5.3 and Statawere employed to carry out meta-analysis on the incidence of adverse respiratory events, myoclonus, abdominal pain, fever, bleeding, chest pain, sore throat, vomiting, and delayed capsule discharge after digestive endoscopy in children. The article quality was evaluated by the Agency for Healthcare Research and Quality (AHRQ). The chi-square test and I 2 were adopted to test literature heterogeneity, and the article publication bias was assessed by displaying an inverted funnel plot as a funnel plot.Results: In all, 15 articles were included, involving a total of 27,770 children. In all, 15 articles were included, involving a total of 27,770 children. The risk ratio (RR) value of adverse respiratory events after digestive endoscopy in children was 1.31 [95% confidence interval (CI): 1.17 to 1.47, P<0.00001]; the odds ratio (OR) value of the incidence of myoclonus was 1.

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“…In this study, although CS did not identify lesions in the colon, three patients were found to have lesions in the terminal ileum, which could be diagnosed via SBCE. Although CS is widely performed on children, is safe ( 9 ), and may lead to a definitive diagnosis by biopsy, the rate of diagnosing a lesion in cases in which the colon is the bleeding source is low. In addition, in severe cases, bowel preparation is often not possible, making the identification of the source of bleeding difficult.…”

Section: Discussionmentioning

confidence: 99%

Causes of Melena and Effective Examination Strategies in Children

et al. 2021

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Background and Aim: Melena, or tarry black stool, is not a rare symptom encountered in pediatric clinical practice, and the bleeding source varies from the upper gastrointestinal tract to the small intestine. Endoscopy is effective in identifying bleeding, but it does not always identify the source of bleeding. Endoscopic examination in children is commonly challenging, and there are no detailed reports about the causes of melena in children. This observational study aimed to validate the cause of melena in children and to investigate more effective and less burdensome examination methods.Methods: We retrospectively reviewed the clinical records of 55 patients who underwent examination for melena.Results: In this research, 38 patients had underlying diseases such as malignancy and severe mental and physical disorders. The bleeding source was identified in 39 patients. The most common final diagnosis was duodenal ulcer (n = 22), and the other diagnoses were gastric ulcer, esophagitis, and esophageal varices. The upper gastrointestinal tract was the most common source of bleeding (n = 34). In five patients, the bleeding source was the small intestine. Vomiting, abnormal abdominal ultrasonography findings, and a hemoglobin level of ≤ 3 g/dL than the lower normal limit were significant factors indicating that the bleeding source can be found on esophagogastroduodenoscopy.Conclusions: The upper gastrointestinal tract was the most common bleeding source of melena in children. As in adults, esophagogastroduodenoscopy is the primary endoscopic method of choice. Furthermore, small bowel capsule endoscopy may be useful in identifying the bleeding source in children without upper gastrointestinal lesions.

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Nationwide survey of pediatric gastrointestinal endoscopy in Japan

Cited by 10 publications

References 30 publications

The utility and safety of paediatric endoscopy in a district general hospital in Southeast England

The utility and safety of paediatric endoscopy in a district general hospital in Southeast England

Systematic review and meta-analysis of the incidence rates of adverse events after digestive endoscopy in children

Causes of Melena and Effective Examination Strategies in Children

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