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Published on: August 1, 2019
A prospective audit of paediatric colonoscopy under general anaesthesia
M D Stringer1, A Pinfield, L Revell
1Department of Paediatric Surgery, Leeds Teaching Hospitals Trust, UK.
Insights
General anaesthesia is a safe and effective option for pediatric colonoscopy. This study found no complications in 250 procedures, demonstrating its feasibility for children undergoing colonoscopy and related interventions.
Area of Science:
- Pediatric Gastroenterology
- Anesthesiology
Background:
- Colonoscopy in children often uses intravenous sedation.
- General anesthesia for pediatric colonoscopy has been viewed as potentially hazardous.
Purpose of the Study:
- To prospectively audit pediatric colonoscopies performed under general anesthesia.
- To analyze the safety and efficacy of this approach.
Main Methods:
- Prospective data collection over 3.5 years for all referred children.
- Analysis of safety and efficacy of colonoscopy under general anesthesia.
- 250 colonoscopies performed in 215 children (median age 10.7 years).
Main Results:
- 164 ileoscopies were performed.
- An increasing number of day-case procedures were conducted.
- No complications occurred during colonoscopy, including 18 polypectomies.
- Only one avoidable procedure-related complication was noted.
Conclusions:
- Pediatric colonoscopy under general anesthesia is safe.
- This approach offers advantages and is feasible for pediatric patients.
- Supports the use of general anesthesia for pediatric colonoscopy.
Abstract:
Colonoscopy in children is frequently performed using intravenous sedation. Traditionally, there have been few advocates of general anaesthesia and some have regarded colonoscopy conducted in this way as potentially more hazardous. The aim of this study was to undertake a prospective audit of paediatric colonoscopy carried out under general anaesthesia. The details of all children referred for colonoscopy during a 3.5-y period were collected prospectively and the safety and efficacy of performing colonoscopy under general anaesthesia were analysed. A total of 250 colonoscopies was performed in 215 children of median age 10.7 y (range 5 months to 16 y) and ileoscopy was carried out in 164 of these cases. An increasing proportion of patients was investigated as day-cases, including most of the 56 who had additional procedures carried out under the same anaesthetic. There were no complications from the colonoscopy (including the 18 patients who underwent polypectomy). Only one procedure-related complication occurred and this was avoidable. These results confirm the safety of paediatric colonoscopy under general anaesthesia and demonstrate the advantages and feasibility of such an approach.
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