Gastroscopy in Pediatric Surgery: Indications, Complications, Outcomes, and Ethical Aspects
Table 1
Summary of the numbers and types of outcomes in the five indication groups.
Indication group
Outcome, percentage of patients ()
Obstruction in upper gastrointestinal tract
(i) Dilatation of stenosis, 55% (41) (ii) Calibration, 29% (22) (iii) Inspection with positive findings, 8% (6) (iv) Inspection with negative findings, 7% (5) (v) Mapping before atresia surgery, 1% (1)
Gastroesophageal reflux disease
(i) No positive findings at either of the following aspects: inspection of mucosa/inspection of cardiac function/biopsy/24-hour pH measurement, 51% (29), of which 10% (3) led to dose change in proton pump inhibitor (PPI) treatment and 90% (26) led to no change of treatment (ii) Positive findings at one or more of the following aspects: inspection of mucosa/inspection of cardiac function/biopsy/24-hour pH measurement, 47% (27), of which 30% (8) led to starting up with/dose escalation of PPI, 7% (2) led to decision of fundoplication, 7% (2) led to further investigation, and 56% (15) led to no action taking/no change of treatment (iii) Calibration, 2% (1)
Investigation of gastroenterological conditions
(i) No positive findings at inspection/biopsy, 46% (39), of which 23% (9) led to further investigation/treatment with gluten-free diet and 77% (30) led to no action taking/no change of treatment (ii) One or more positive findings at inspection/biopsy, 50% (42), of which 69% (29) led to treatment with gluten-free diet/PPI/eradication treatment of helicobacter pylori/total parenteral nutrition, 12% (5) led to further investigation, and 19% (8) led to no action/no change of treatment (iii) Inconclusive findings, 4% (3)
Laparoscopic gastrostomy
(i) Inspection of the placement of gastrostomy and signs of esophagitis, 100% (150) (of which none showed signs of esophagitis)
Other
(i) Removal of foreign body, 60% (6) (ii) Rubber band ligation of varices, 20% (2) (iii) Placement of capsule for video endoscopic examination, 20% (2)
