Safety of double-balloon enteroscopy in postoperative pediatric patients.
complication
double-balloon enteroscopy
pediatric
postoperative procedure
Journal
Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Titre abrégé: Pediatr Int
Pays: Australia
ID NLM: 100886002
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
17
07
2019
revised:
03
04
2020
accepted:
09
04
2020
pubmed:
17
4
2020
medline:
19
5
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
The aim of the present study was to investigate the efficacy and safety of double-balloon enteroscopy (DBE) in postoperative pediatric patients. This was a retrospective analysis of pediatric patients 18 years and younger referred to Mie University Hospital. Twenty procedures in 11 children occurred postoperatively; 29 children (42 procedures) had not undergone surgery. Among postoperative patients, five DBE procedures were performed via the oral route, 12 via the anal route, and three via a stomal route. Among nonoperative patients, 14 DBE procedures were performed via the oral route and 28 via the anal route. Four postoperative patients and two nonoperative patients had difficult pleating via the transanal route because of adhesions or thickening of the intestinal wall resulting from inflammation (P = 0.02). Excluding patients with stenosis, the mean length of endoscopic insertion for transanal procedures was significantly shorter among postoperative patients than among nonoperative patients (73.6 cm vs 160.5 cm, P < 0.01). There were no major complications in either group. Insertion difficulty was encountered in postoperative pediatric patients. However, our findings indicate that DBE is a safe procedure in postoperative pediatric patients.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of the present study was to investigate the efficacy and safety of double-balloon enteroscopy (DBE) in postoperative pediatric patients.
METHODS
METHODS
This was a retrospective analysis of pediatric patients 18 years and younger referred to Mie University Hospital. Twenty procedures in 11 children occurred postoperatively; 29 children (42 procedures) had not undergone surgery.
RESULTS
RESULTS
Among postoperative patients, five DBE procedures were performed via the oral route, 12 via the anal route, and three via a stomal route. Among nonoperative patients, 14 DBE procedures were performed via the oral route and 28 via the anal route. Four postoperative patients and two nonoperative patients had difficult pleating via the transanal route because of adhesions or thickening of the intestinal wall resulting from inflammation (P = 0.02). Excluding patients with stenosis, the mean length of endoscopic insertion for transanal procedures was significantly shorter among postoperative patients than among nonoperative patients (73.6 cm vs 160.5 cm, P < 0.01). There were no major complications in either group.
CONCLUSIONS
CONCLUSIONS
Insertion difficulty was encountered in postoperative pediatric patients. However, our findings indicate that DBE is a safe procedure in postoperative pediatric patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1073-1076Informations de copyright
© 2020 Japan Pediatric Society.
Références
Yamamoto H, Sekine Y, Sato Y et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest. Endosc. 2001; 53: 216-20.
Kita H, Yamamoto H. New indications of double balloon endoscopy. Gastrointest. Endosc. 2007; 66(3 Suppl): S57-9.
Ginsberg GG, Pickett-Blakely O. Endoscopy unit considerations in the care of obese patients. Gastrointest. Endosc. Clin. N. Am. 2011; 21: 265-74.
Raithel M, Dormann H, Naegel A et al. Double-balloon-enteroscopy-based endoscopic retrograde cholangiopancreatography in post-surgical patients. World J. Gastroenterol. 2011; 17: 2302-14.
Nishimura N, Yamamoto H, Yano T et al. Safety and efficacy of double-balloon enteroscopy in pediatric patients. Gastrointest. Endosc. 2010; 71: 287-94.
Sanada Y, Mizuta K, Yano T et al. Double-balloon enteroscopy for bilioenteric anastomotic stricture after pediatric living donor liver transplantation. Transpl. Int. 2011; 24: 85-90.
Ono S, Maeda K, Baba K et al. The efficacy of double-balloon enteroscopy for intrahepatic bile duct stones after Roux-en-Y hepaticojejunostomy for choledochal cysts. Pediatr. Surg. Int. 2013; 29: 1103-7.
Tanaka S, Mitsui K, Tatsuguchi A et al. Current status of double balloon endoscopy-indications, insertion route, sedation, complications, technical matters. Gastrointest. Endosc. 2007; 66(3 Suppl): S30-3.
May A, Nachbar L, Pohl J, Ell C. Endoscopic interventions in the small bowel using double balloon enteroscopy: Feasibility and limitations. Am. J. Gastroenterol. 2007; 102: 527-35.
Heine GD, Hadithi M, Groenen MJ, Kuipers EJ, Jacobs MA, Mulder CJ. Double-balloon enteroscopy: Indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease. Endoscopy 2006; 38: 42-8.
Mensink PB, Haringsma J, Kucharzik T et al. Complications of double balloon enteroscopy: a multicenter survey. Endoscopy 2007; 39: 613-615. Published online 21 May 2007.
Khashab M, Helper DJ, Chiorean MV et al. Predictors of depth of maximal insertion at double-balloon enteroscopy. Dig Dis. Sci. 2010; 55: 1391-5.
Yamamoto H, Kita H, Sunada K et al. Clinical Outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin. Gastroenteral. Hepatol. 2004; 2: 1010-16.
de Ridder L, Tabbers MM, Escher JC. Small bowel endoscopy in children. Best Pract. Res. Clin. Gastroenterol. 2012; 26: 337-45.
Spahn TW, Kampmann W, Eilers M et al. Small-bowel perforation after endoscopic resection of a Peutz-Jeghers polyp in an infant using double-balloon enteroscopy. Endoscopy 2007; 39(Suppl 1): E217.
Bizzarri B, Borrelli O, de'Angelis Net al. Management of duodenal-jejunal polyps in children with Peutz-Jeghers syndrome with single-balloon enteroscopy. J. Pediatr. Gastroenterol. Nutr. 2014; 59: 49-53.
Manes G, Imbesi V, Ardizzone S et al. Use of double-balloon enteroscopy in the management of patients with Crohn's disease: Feasibility and diagnostic yield in a high-volume centre for inflammatory bowel disease. Surg. Endosc. 2009; 23: 2790-5.
Voderholzer WA. The role of PillCam endoscopy in Crohn's disease: The European experience. Gastrointest. Endosc. Clin. N. Am. 2006; 16: 287-97.
Sunada K, Yamamoto H, Yano T et al. Advances in the diagnosis and treatment of small bowel lesions with Crohn's disease using double-balloon endoscopy. Therap. Adv. Gastroenterol. 2009; 2: 357-66.
Yokoyama K, Yano T, Kumagai H et al. Double-balloon enteroscopy for pediatric patients: evaluation of safety and efficacy in 257 cases. J. Pediatr. Gastroenterol. Nutr. 2016; 63: 34-40.
Di Nardo G, Oliva S, Aloi M et al. Usefulness of single-balloon enteroscopy in pediatric Crohn's disease. Gastrointest. Endosc. 2012; 75: 80-86.