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Paediatric Gastrointestinal Endoscopy by Adult Gastroenterologists: A Retrospective Study Addressing the Outcome and Safety of Performing Endoscopies in Resource-Poor Setting
 
Arya Suchismita1, Ashish Kumar Jha1, Vishwa Mohan Dayal1, Jayant Prakash2, Anand Kumar Gupta2, Rakesh Kumar2, Rizwan Ahmer2
1Department of Gastroenterology, 2Department of Paediatrics, Indira Gandhi Institute of Medical Sciences, Patna, India.


Corresponding Author
:
Dr. Ashish Kumar Jha
Email: ashishjhabn@yahoo.co.in


Abstract

Background: Paediatric endoscopic procedures are mostly performed by the paediatric gastroenterologist with paediatric endoscopes under general anesthesia (GA) or, under deep sedation. Data regarding the outcome and safety of paediatric endoscopy performed by an adult gastroenterologist are limited. 
Methods: We aimed to investigate indications, the use of sedation, endoscopic findings, and outcomes of paediatric endoscopic procedures performed by the adult gastroenterologists. We also analyzed the success rate of upper gastrointestinal endoscopy (UGIE) performed with adult gastroscopes in children weighing 5 to 10 kg. In a retrospective study, case record of paediatric patients (age up to 15 years) who underwent UGIE and lower GI endoscopy (LGIE) were reviewed.
Result: Out of 391 patients, UGIE was successfully completed in 383 (98%) patients. The mean (SD) age was 7.7 (3.3) years. 28% of the children required mild sedation or GA for the procedure. Successful UGIE with adult gastroscopes was possible in 23 (82%) of 28 young children (weighing 5-10 kg). The endoscopic yield was 65.54%. Therapeutic UGIE were done in 39.16% of patients. Out of 123 patients, LGIE was successfully completed in 120 (97.95%) patients (sigmoidoscopy: 81.66%, colonoscopy: 18.33%). The mean (SD) age was 7.9 (3.3) years. 27% of the children were given mild sedation or GA for the procedure. The endoscopic yield was 75%. Therapeutic LGIE were performed in 44% of patients. 
Conclusion: Paediatric GI endoscopy can be safely performed by an experienced adult gastroenterologist. Unsedated UGIE and sigmoidoscopy can be well-tolerated by children when performed by appropriate monitoring.