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105 COMBINED UPPER AND LOWER ENDOSCOPY IN CHILDREN: DOES THE ORDER OF PROCEDURE AFFECT PROCEDURE COMPLETION RATE? H Brill, Forget S OBJECTIVE: Upper endoscopy (UE) and lower endoscopy/colonoscopy (LE) are essential diagnostic tools in pediatric gastroenterology. Often, children require both procedures during the same patient encounter. The purpose of this study was to determine if the completion rate is affected by the order in which the procedures are performed.
McGill University Health Center, Montreal, Quebec
METHODS: We retrospectively reviewed all endoscopies performed at the Montreal Children's Hospital between January 1, 2003 and September 30, 2005. Patient encounters in which both UE and LE were performed were selected for analysis, excluding rectosigmoidoscopies and ileoscopies. Children receiving UE first were compared with those receiving LE first, and completion rate of all procedures was recorded. For UE, the procedure was considered complete if the duodenum was reached and biopsies successfully obtained. LE was considered complete if the terminal ileum was reached, except in the case of familial polyposis where reaching the cecum was sufficient. Data was analyzed using
RESULTS: Of 1089 patient encounters during the study period, 714 had only UE, 142 had only LE and 233 involved both procedures. Sedation was used in 153 cases, while 80 cases were done under general anesthesia (GA). Results are summarized in the table.
Order of procedure
Complete
Incomplete
Total
UE first
87
35
122
LE first
87
24
111
Total
174
59
233
Although there is a trend toward higher completion rate when LE was performed first, the results were not statistically significant (P£1). There was no difference between sedation and GA.
CONCLUSIONS: In patients undergoing UE and LE consecutively, there is no statistically significant difference in procedure completion rate according to the order in which procedures are performed.