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[Progress and focal points discussed at the Japanese Committee on Pediatric Endoscopy]
Insights
Pediatric endoscopy is advancing, improving diagnostic accuracy for conditions like peptic ulcers and biliary atresia in infants. However, increased procedures highlight the need for specialized training programs for pediatric endoscopists.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Surgery
- Diagnostic Endoscopy
Context:
- Pediatric endoscopy has seen significant technical and instrumental advancements.
- These improvements have led to safer procedures and an increased volume of pediatric endoscopies performed.
- The rise in procedures necessitates a discussion on training standards.
Purpose:
- To review recent advances in pediatric endoscopy techniques and instrumentation.
- To highlight the diagnostic utility of endoscopy in neonates and infants for conditions like hematemesis and jaundice.
- To address the challenges and training needs for pediatric endoscopists.
Summary:
- Gastric endoscopy aids in diagnosing peptic ulcers in newborns with hematemesis.
- Endoscopic retrograde cholangiopancreatography (ERCP) is effective in differentiating biliary atresia from infantile hepatitis in neonates.
- Colonofiberscopy is a valuable tool for identifying sources of rectal bleeding, though further improvements are needed.
Impact:
- Increased diagnostic capabilities for gastrointestinal and hepatobiliary conditions in pediatric patients.
- Established use of anesthesia, with general anesthesia being common and local anesthesia considered for older children.
- A near doubling of pediatric endoscopies between 1978 and 1983 underscores the growing importance and application of these procedures.
Abstract:
Recent advances of pediatric endoscopy were discussed. Progresses of technique and improvements of instrument have made it possible to scope safely resulting in the increase of pediatric endoscopies. Gastric endoscopy has become useful to find the peptic ulcer of the stomach in the newborn babies who showed hematemesis. ERCP has been done successfully in the newborn babies making it possible to differentiate congenital biliary atresia from infantile hepatitis. Colonofiberscopy has become reliable and useful procedure to search the source of rectal bleeding but still had some problems to be resolved. General anesthesia has been widely used at the performance of pediatric endoscopy. In some institutes, local anesthesia has been recommended in the patients over 8 years old. In 1983, 1161 pediatric endoscopies were performed in 24 institutes, which were twofold of those performed in 1978. Number of these cases is not enough for the training of pediatric endoscopist. Urgent theme is to establish the system for the education of "true" pediatric endoscopist.