Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Saitama Prefecture.
Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo.
J Pediatr Gastroenterol Nutr. 2019 Mar;68(3):306-310. doi: 10.1097/MPG.0000000000002181.
The benefit of balloon-assisted enteroscopy (BAE) had been recently documented in pediatric patients, but previous reports are based on single institution experiences. We evaluated the feasibility of pediatric BAE in 8 tertiary referral hospitals throughout Japan.
This was a prospective, multi-institutional study. Patients younger than 18 years were enrolled between April 2014 and March 2017 to undergo double-balloon or single-balloon enteroscopy. Data were collected prospectively using a standardized questionnaire.
We enrolled 79 pediatric patients (96 procedures, 70 boys, 26 girls; median age 12.7 years, range 1-17 years). Antegrade (oral-route) BAE was performed in 20 procedures (lowest body weight 12.9 kg, youngest age 3.7 years), and retrograde (anal-route) BAE in 76 (lowest body weight 10.8 kg, youngest age 1.6 years). Severe adverse events were associated with BAE in 2 patients: 1 with hemorrhage due to polypectomy and 1 with pancreatitis after double-balloon endoscopic retrograde cholangioscopy. No intestinal perforation was reported. Procedure duration of oral-route BAE for diagnosis was significantly longer than anal-route for diagnosis (P < 0.001). The overall diagnostic yield for rectal bleeding/positive fecal occult blood test and abdominal pain was 48%. Among 40 patients referred for diagnosis who did not undergo capsule endoscopy, diagnoses were confirmed in 17 (42.5%) patients after BAE.
This prospective multicenter observational study documents the efficacy of BAE in pediatric patients.
气囊辅助式小肠镜（BAE）在儿科患者中的获益已得到近期证实，但之前的报道均基于单中心经验。我们评估了日本 8 家三级转诊医院开展小儿 BAE 的可行性。
这是一项前瞻性、多中心研究。2014 年 4 月至 2017 年 3 月期间，纳入年龄小于 18 岁的患者行双气囊或单气囊小肠镜检查。使用标准化问卷前瞻性收集数据。
我们纳入 79 例儿科患者（96 例次，70 例男，26 例女；中位年龄 12.7 岁，范围 1-17 岁）。经口（逆行）BAE 完成 20 例（最低体重 12.9kg，最小年龄 3.7 岁），经肛（顺行）BAE 完成 76 例（最低体重 10.8kg，最小年龄 1.6 岁）。2 例患者与 BAE 相关出现严重不良事件：1 例因息肉切除术出现出血，1 例行双气囊内镜逆行胰胆管造影术后出现胰腺炎。无肠穿孔发生。诊断性经口 BAE 的操作时间显著长于经肛 BAE（P＜0.001）。直肠出血/粪便隐血试验阳性和腹痛的总体诊断率为 48%。在 40 例因诊断而行胶囊内镜检查但未行 BAE 的患者中，17 例（42.5%）患者经 BAE 后确诊。
这项前瞻性多中心观察性研究证实了 BAE 在儿科患者中的疗效。
