Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Pediatr Int. 2020 Sep;62(9):1073-1076. doi: 10.1111/ped.14249. Epub 2020 Sep 7.
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.
本研究旨在探讨双气囊小肠镜(DBE)在儿科术后患者中的疗效和安全性。
这是一项对转诊至日本三重大学医院的 18 岁以下儿科患者的回顾性分析。11 名儿童中有 20 例(共 29 次)术后接受了 DBE,29 名儿童(共 42 次)未接受手术。
在术后患者中,5 次 DBE 通过口腔入路进行,12 次通过肛门入路进行,3 次通过造口入路进行。在非手术患者中,14 次 DBE 通过口腔入路进行,28 次通过肛门入路进行。由于炎症导致粘连或肠壁增厚,4 例术后患者和 2 例非手术患者经肛门入路时存在褶皱困难(P = 0.02)。排除狭窄患者后,经肛门入路的内镜插入平均长度在术后患者中明显短于非手术患者(73.6cm 比 160.5cm,P < 0.01)。两组均无严重并发症。
在儿科术后患者中,插入存在一定难度。然而,我们的研究结果表明 DBE 在儿科术后患者中是一种安全的方法。