Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Study to determine guidelines for pediatric colonoscopy
Shinichiro Yoshioka, Hidetoshi Takedatsu, Shuhei Fukunaga, Kotaro Kuwaki, Hiroshi Yamasaki, Ryosuke Yamauchi, Atsushi Mori, Hiroshi Kawano, Tadahiro Yanagi, Tatsuki Mizuochi, Kosuke Ushijima, Keiichi Mitsuyama, Osamu Tsuruta, Takuji Torimura
Shinichiro Yoshioka, Shuhei Fukunaga, Kotaro Kuwaki, Hiroshi Yamasaki, Ryosuke Yamauchi, Atsushi Mori, Hiroshi Kawano, Keiichi Mitsuyama, Osamu Tsuruta, Takuji Torimura, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Asahi-machi Kurume, Fukuoka 830-0011, Japan
Hidetoshi Takedatsu, Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Jonan-ku, Fukuoka 814-0180, Japan
Tadahiro Yanagi, Tatsuki Mizuochi, Kosuke Ushijima, Department of Pediatrics and Child Health Kurume University School of Medicine, Asahi-machi Kurume, Fukuoka 830-0011, Japan
Author contributions: Yoshioka S and Takedatsu H contributed equally to this work; Yoshioka S, Takedatsu H, Mitsuyama K and Torimura T designed the research; Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, Mori A, Kawano H, Tsuruta O, Yanagi T, Mizuochi T and Ushijima K performed the research; Yoshioka S and Takedatsu H analyzed the data; Yoshioka S and Takedatsu H wrote the paper.
Institutional review board statement: The study was reviewed and approved by The Ethical Committee of Kurume University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of Kurume University.
Conflict-of-interest statement: None of the authors have any conflict of interest disclosures to make.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hidetoshi Takedatsu, MD, PhD, Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. takedatsu@fukuoka-u.ac.jp
Telephone: +81-92-8011011 Fax: +81-92-8742663
Received: April 27, 2017
Peer-review started: April 27, 2017
First decision: June 8, 2017
Revised: June 23, 2017
Accepted: July 12, 2017
Article in press: July 12, 2017
Published online: August 21, 2017
AIM
To investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy.
METHODS
The present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon.
RESULTS
Hematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease (n = 49, 44.5%), including ulcerative colitis (n = 37, 33.6%) and Crohn’s disease (n = 12, 10.9%), was the most common diagnosis.
CONCLUSION
Colonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients.
Core tip: A guideline for pediatric colonoscopy management have yet to be established in Japan. We investigated clinical characteristics, diagnostic utility, bowel cleansing preparation, sedation, and colonoscope length and diameter under 15 years of age who had undergone their first colonoscopy in our institution. Our results revealed that the symptoms associated with the indication of pediatric colonoscopy were hematochezia, abdominal pain, and diarrhea. Positive diagnoses were obtained in a majority of pediatric patients. More than 40% of patients were diagnosed with inflammatory bowel disease. Thus, our findings demonstrate the utility of colonoscopy as a diagnostic tool in pediatric patients with gastrointestinal symptoms.
