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Colonoscopy in infancy and childhood with special regard to patient preparation and examination technique
Insights
This study details pediatric colonoscopy techniques using long colonoscopes in 76 children. Researchers found specific procedural modifications and anesthesia methods effective, achieving high success rates with no complications.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
Background:
- Colonoscopy in pediatric patients presents unique challenges.
- Standardized techniques and appropriate sedation/anesthesia are crucial for successful outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of specific colonoscopy techniques in pediatric patients.
- To identify optimal examination methods and anesthetic protocols for pediatric colonoscopy.
Main Methods:
- Utilized long colonoscopes (Olympus CF-LB2 or TCF-2L) for 76 pediatric colonoscopies.
- Employed a pre-procedure regimen including a thin-liquid diet, laxatives, and saline enemas for larger children.
- Administered premedication (chlorpromazine, promethazine, pethidine chloride, atropine sulfate) and anesthesia (diazepam, ketamine, or halothane-based inhalation) or sedation (diazepam, fentanyl citrate).
Main Results:
- The cecum was reached in 75% of all examinations.
- No complications were reported during or after the pediatric colonoscopies.
- Both the 'classical' technique and Gaisford's modification proved suitable for infants and children.
Conclusions:
- Pediatric colonoscopy can be performed safely and effectively using long colonoscopes.
- Specific preparation protocols and anesthetic/sedation strategies contribute to successful outcomes.
- The described techniques offer a reliable approach for pediatric gastrointestinal examinations.
Abstract:
Only long colonoscopes, Olympus CF-LB2 or TCF-2L, were used for the 76 pediatric colonoscopies. A combination of a thin-liquid diet and laxatives was employed for 1-2 days before all the examinations. Physiological saline enemas on the eve and the morning of the day of examination were employed as supplementary colon-cleansing measures only in larger children. A mixture consisting of chlorpromazine, promethazine and pethidine chloride supplemented with atropine sulfate was used for premedication. Diazepam and ketamine chloride given i.v., or inhalation of halothane +N2O+O2 were employed for general anesthesia. Diazepam and phentanyl citrate given intravenously were used for the sedation of older children. The "classical" and Gaisford's modification of the procedure were found to be the most suitable examination techniques in infants and children. The coecum was reached in 75% of all examinations, and we had no complications with pediatric colonoscopy.