Liman Andrew, Koh Linda, Barakat Monique, Abu El Haija Marwa
Department of Pediatrics, School of Medicine Division of Pediatric Gastroenterology, Hepatology & Nutrition Stanford University Stanford California USA.
Department of Internal Medicine, School of Medicine Division of Gastroenterology and Hepatology Stanford California USA.
JPGN Rep. 2024 Jun 24;5(3):243-249. doi: 10.1002/jpr3.12095. eCollection 2024 Aug.
Our objective was to summarize the available literature on the use of preoperative esophagogastroduodenoscopy (EGD) and its impact on management and/or postoperative outcomes in pediatric patients undergoing metabolic and bariatric surgery. We performed a search using PubMed in February 2023 for articles examining EGD and any clinical correlation in pediatric patients undergoing bariatric surgery. Search results were manually reviewed and included in the study if they examined findings of EGD done prior to bariatric surgery and were excluded if they were not primarily done in pediatric or adolescent patients. Our search yielded 549 distinct articles, with a total of four articles remaining after applying inclusion and exclusion criteria. All four studies were retrospective. A total of 244 patients were studied, with an age range of 9-25 years. Of the patients whose respective findings were reported, 21/150 patients (14%) had esophagitis, 55/150 (37%) had gastritis, 55/244 (23%) had , and 18/150 (12%) had duodenitis. There were a total of 60 findings that changed medical management, and one that changed surgical management. A high proportion of positive EGD findings that changed medical management was evident, and one study suggested that mucosal inflammation may be a prognostic indicator for postoperative weight loss. However, there is a paucity of data examining the utility of routine EGD prior to bariatric surgery, specifically in pediatric patients, and more studies are therefore needed to construct the evidence basis for guidelines.
我们的目标是总结关于术前食管胃十二指肠镜检查（EGD）的现有文献，以及其对接受代谢和减重手术的儿科患者的管理和/或术后结果的影响。我们于2023年2月在PubMed上进行了检索，以查找有关EGD以及接受减重手术的儿科患者的任何临床相关性的文章。对检索结果进行了人工审核，如果文章研究了减重手术前进行的EGD的结果，则纳入研究；如果文章并非主要针对儿科或青少年患者，则排除。我们的检索产生了549篇不同的文章，应用纳入和排除标准后，总共剩下4篇文章。所有4项研究均为回顾性研究。总共研究了244例患者，年龄范围为9至25岁。在报告了各自检查结果的患者中，21/150例患者（14%）患有食管炎，55/150例（37%）患有胃炎，55/244例（23%）患有[此处原文缺失内容]，18/150例（12%）患有十二指肠炎症。总共有60项检查结果改变了医疗管理，1项改变了手术管理。明显有很大比例的阳性EGD检查结果改变了医疗管理，并且有一项研究表明黏膜炎症可能是术后体重减轻的预后指标。然而，关于减重手术前常规EGD的效用的数据较少，特别是在儿科患者中，因此需要更多的研究来构建指南的证据基础。
