Paediatric endoscopy in Spain: Current situation and recent developments

Abstract

INTRODUCTION: Paediatric gastrointestinal endoscopy (pGIE) has advanced significantly over the last decade, with increased diagnostic and therapeutic applications. OBJECTIVES: This study examines the current state of pGIE in Spain, changes in the field over 5 years, and the involvement of paediatric gastroenterologists (pGEs). MATERIALS AND METHODS: A structured self-administered questionnaire was distributed by the Endoscopy Working Group of the Spanish Society of Paediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) through the REDCap platform. The questionnaire included questions concerning techniques, sedation, indications, and organizational barriers. We compared the results with data from 2015. RESULTS: Eighty-one of the 103 invited hospitals participated (66.4%). Paediatric gastroenterologists performed 71% of scheduled pGIEs and 24% of emergency pGIEs. Therapeutic endoscopies accounted for 72% of procedures, including foreign body removal (50%) and polypectomy (36%), and were performed by pGEs in 61% and 63% of cases, respectively. When it came to other procedures, pGEs performed 24% in the case of hydrostatic dilation, 20% in the case of variceal sclerotherapy and of haemoclip placement, and 18% in the case of endoscopic coagulation. None of the endoscopic ultrasound, endoscopic retrograde cholangiopancreatography or enteroscopy procedures were performed by pGEs. Sedation was administered by anaesthesiologists in 70% of cases. Compared to 2015, there was an increase in the scheduled endoscopies performed by pGEs (71% vs 54%), the performance of gastroscopies (>180 per year in 61% vs 24%) and colonoscopies (60-120 per year in 31% vs 12%) and the use of picosulfate for colonoscopy preparation (44% vs 10%). CONCLUSIONS: There has been a significant increase in the involvement of pGEs in pGIE in Spain, although of lesser magnitude in emergency and therapeutic endoscopy procedures.