Lütfi Hakan GÜNEY, Ender FAKIOĞLU, Tuğba ACER DEMİR

Pediatrik Cerrahi Pratiğinde Üst Gastrointestinal Endoskopi

Amaç: Çalışmamızda endoskopi gerektiren özofagus bozukluğu olan çocuk hastaların demografik özelliklerini, bu hastalarda rijid ve bükülebilir endoskopi endikasyonlarını, işlem komplikasyonlarını ve sonuçlarını değerlendirdik. Gereç ve Yöntemler: Ocak 2005 - Şubat 2020 tarihleri arasında endoskopi planlanan çocukların kayıtları incelendi. Klinik veriler, endoskopi yöntemleri, sonuç ve komplikasyonlar araştırıldı. Bükülebilir endoskopi (BE) ve rijid endoskopi (RE) grupları karşılaştırıldı. Bulgular: Toplam 242 olgu saptandı. Yetmişi yabancı cisim yutma (%28.9), 89’u kostik madde içme (%36.8), 52’si özofagus darlığı (%21.5) ve 31’i diğer nadir durum (%12.8) olgularıydı. Kırk iki hastaya, onam verilmediği için endoskopi yapılmadı. Ortalama yaş 36.4±35.7 aydı. Olguların 102’sine (%42.1) RE, 98’ine (%40.5) BE uygulandı. İki grubun ortalama arasında istatistiksel olarak anlamlı fark yoktu (33.3±32.1 ve 33.7±24.9 ay, p=0.918). BE yapılan hastaların çoğunlukla erkek olduğu (BE grubunda %2, RE grubunda %39.2, p=0.046). RE grubunda komplikasyon oranı %6.9’di ve BE grubunda ise komplikasyon yoktu (p=0.008). Gruplar arasında başarısızlık oranı açısından anlamlı bir fark yoktu (RE’de %3.9 ve BE’de 0, p=0.066). Sonuç: Hem rijid hem de bükülebilir endoskopi teknikleri, özofagus hastalıklarında tanısal veya terapötik olarak etkili ve güvenli olarak kullanabilir. Her birine özgü avantaj ve kısıtlılıklarla birlikte, rijid endoskopinin komplikasyon riski daha yüksektir.

Anahtar Kelimeler:

Endoskopi, Çocuk, Özofagus

Upper Gastrointestinal Endoscopy in Pediatric Surgical Practice

Objective: We aimed to focus descriptively and comparatively on the children with esophageal disorders requiring endoscopy: demographics, indications, methods, complications and outcomes. Material and Methods: The records of the children with esophageal disorders indicative of endoscopy between January 2005 and February 2020 at the department of pediatric surgery of a tertiary health care center were reviewed in terms of demographic, etiological, technical aspects; including the comparison of flexible endoscopy (FE) and rigid endoscopy (RE). Results: Endoscopy was indicated in a total of 242 children for foreign body ingestion (n=70, 28.9%), caustic ingestion (n=89, 36.8%), esophageal stricture (n=52, 21.5%) and other rare conditions (n=31, 12.8%). Fourty two of them did not undergo endoscopy, because their caregivers did not consent. Of the rest; 102 (42.1%) underwent RE, and 98 (40.5%) underwent FE. The mean age was 36.4±35.7 months. No statistically significant difference was detected between the mean ages of RE and FE groups (33.3±32.1 vs. 33.7±24.9 months, p=0.918). Most of the patients who underwent FE were significantly males (52% in FE group, 39.2% in RE group, p=0.046). Complication rate was 6.9% in RE group and no complication was detected in FE group (p=0.008). The difference of failure rates of the groups was statistically insignificant (3.9% in RE vs 0 in FE, p=0.066). Conclusion: Both rigid and flexible endoscopy techniques are effective and safe for diagnostic or therapeutic esophageal interventions. Although each has its own advantages an disadvantages, performing rigid endoscopy takes a slightly but significantly higher risk of complication.

Keywords:

Children, Endoscopy, Esophagus,

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