目的:在因短肠综合征引起的肠衰竭(IF)的儿科患者中,我们假设年幼的孩子,残余小肠较短的患者和先天性肠旋转不良的患者更有可能接受泛小肠镜检查.我们的目的是确定该队列中泛肠镜检查的可行性和诊断率。
方法:我们执行了单中心,回顾性研究2018年1月1日至2023年1月1日期间接受至少一次胃肠道内镜评估的短肠综合征(SBS)导致IF的儿科患者.
结果:在所审查的431例手术(206例患者)中,有381例可能进行了全肠镜检查。44例(21%)患者接受了54例泛肠镜检查。残余肠长<35厘米的儿童接受全肠镜检查的几率更高(比值比[OR]3.72,95%置信区间[CI][1.32,10.48],p=0.01),围手术期使用胰高血糖素样肽2(GLP-2)类似物的患者也是如此(OR4.30,95%CI[1.24,14.95],p=0.02)。诊断为坏死性小肠结肠炎(NEC)以外的患者往往更有可能获得泛小肠镜检查(OR2.73,95%CI[0.95,7.88],p=0.06)。在77.8%和78%的手术中发现了总体和组织病理学异常的证据,分别。未发现并发症。
结论:在一大群SBS患儿中,在14.2%的手术中成功进行了泛小肠镜检查,显微镜异常很常见.较短的残余肠长度,非NEC的潜在诊断,GLP-2类似物的使用通常与成功的全肠镜检查相关,独立于年龄和其他几个因素。这些数据表明,在SBS患者的一部分中,泛小肠镜检查是可行的,并且是高产量的。
OBJECTIVE: In pediatric patients with intestinal failure (IF) due to short bowel syndrome, we hypothesized that young children, those with shorter residual small bowel and those with congenital malrotation of the bowel would be more likely to undergo pan-enteroscopy. We aimed to determine the feasibility and diagnostic yield of pan-enteroscopy in this cohort.
METHODS: We performed a single-center, retrospective study of pediatric patients with IF due to short bowel syndrome (SBS) who had undergone at least one GI endoscopic evaluation between January 1, 2018 and January 1, 2023.
RESULTS: A pan-enteroscopy might have been possible in 381 of the 431 procedures (206 patients) reviewed. 44 (21%) patients underwent 54 pan-enteroscopies. Children with a residual bowel length <35 cm had higher odds of undergoing pan-enteroscopy (odds ratio [OR] 3.72, 95% confidence interval [CI] [1.32, 10.48], p = 0.01), as did patients with periprocedural glucagon-like peptide 2 (GLP-2) analog use (OR 4.30, 95% CI [1.24, 14.95], p = 0.02). Patients with diagnoses other than necrotizing enterocolitis (NEC) tended to be more likely to achieve a pan-enteroscopy (OR 2.73, 95% CI [0.95,7.88], p = 0.06). Evidence of gross and histopathologic abnormalities were found in 77.8% and 78% of the procedures, respectively. No complications were identified.
CONCLUSIONS: In a large cohort of children with SBS, pan-enteroscopy was successfully performed in 14.2% of the procedures and microscopic abnormalities were common. Shorter residual bowel length, underlying diagnoses of non-NEC, and GLP-2 analog use were generally associated with successful pan-enteroscopy, independent of age and several other factors. These data suggest that pan-enteroscopy is feasible and of high-yield in a subset of patients with SBS.