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TÜRKÇE
Oral Presentation - 28
Clinical yield of esophagogastroduodenoscopy and pH-impedance testing in esophageal atresia patients performed according to international guidelines
C Mussies*, M van Lennep*, M Benninga*, R Gorter**, U Krishnan***, M van Wijk*
*Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital Amsterdam UMC, Amsterdam, the Netherlands
**Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Amsterdam, the Netherlands
***Department of Gastroenterology, Sydney Children’s Hospital, Randwick, Australia
Background: According to the ESPGHAN-NASPGHAN guideline, esophageal atresia (EA) patients should routinely undergo esophagogastroduodenoscopy with biopsies (EGD) and/or pH-impedance (pH-MII) for surveillance purposes. It is additionally recommended to perform these procedures when there is a clinical indication: symptoms suggestive of gastroesophageal reflux disease (GERD) or eosinophilic esophagitis (EoE).
Aim: To evaluate how often EGD/pH-MII outcomes change management decisions in EA children who come for surveillance and/or for clinical evaluation of their symptoms.
Methods: Retrospective chart review of all EA patients who were prospectively evaluated with EGD and/or pH-MII for routine surveillance or because of clinical indication according to the guidelines. For each procedure, we assessed whether outcomes changed management decisions.
Results: Between 2017-2020, 41 patients (median age 2,0 [1,0-17,5]yrs) underwent EGD/pH[1]MII for surveillance purposes and 64 (3,0 [0.1-15.8]yrs) for symptom evaluation. Of the 41 patients that underwent surveillance EGD/pH-MII, 18 (43.9%) were asymptomatic when interviewed. Eight of these 18 (44,4%) had results that changed management decisions. In total, 23/41 (56,1%) had results that changed management decisions. Sixty-four patients presented clinically with (a combination of) dysphagia (n=50; 78,1%), regurgitation (n=37; 57,8%), heartburn (n=18; 28,1%) and/or respiratory symptoms that were thought to have a gastrointestinal origin (n=24; 37,5%). Results changed management decisions in 34/64 (53,1%) patients that presented with symptoms.
Conclusion: There is a high clinical yield of EGD and pH-MII testing in EA patients. More than half of the patients, regardless of indication (routine surveillance or symptom evaluation), had EGD and/or pH-MII results that changed clinical management decisions.