ここまでできる小児消化器内視鏡治療

Advancing pediatric GI endoscopic treatments

要旨

消化器内視鏡が診断に必須である疾患の患者数増加，スコープの細径化や技術の向上に伴って小児に対しても消化器内視鏡検査件数が増加している。本邦における内視鏡治療の報告は少ないが，日本小児内視鏡研究会が主体となり小児内視鏡についての全国調査が行われ，実施状況や偶発症について報告された。また，2022年には5回目の小児消化器内視鏡全国調査が実施された。小児の内視鏡治療は5年間で5,371件に実施されており，バルーン拡張術25.5％，異物除去術19.0％，ポリープ切除術17.8％，内視鏡的胃瘻造設術16.8％，胃食道静脈瘤治療6.5％，内視鏡的止血術4.2％，ステント留置術3.3％などであった。偶発症は103件（1.92％）で認められ，内視鏡治療による死亡例はみられなかった。小児の内視鏡治療件数についても徐々に増加傾向であり，成人と同様な治療を行えることも多くなってきた。小児に対する消化器内視鏡治療について概説する。

　The number of gastrointestinal endoscopies performed on pediatric patients is increasing as a result of the increase in the number of patients with diseases for which endoscopes are necessary for diagnosis, the development of small-caliber scopes, and the improvement of endoscopic techniques. Although there are few reports on endoscopic treatment in Japan, nationwide surveys on pediatric endoscopy have been conducted four times by the Japan Pediatric Endoscopy Study Group, and the status of endoscopy and adverse events have been reported. In 2022, the fifth nationwide survey on pediatric gastrointestinal endoscopy was conducted. Pediatric endoscopic treatments were performed in 5,371 cases over the 5-year period, including balloon dilation in 25.5%, foreign body removal in 19.0%, polypectomy in 17.8%, endoscopic gastrostomy in 16.8%, treatment of gastroesophageal varices in 6.5%, endoscopic hemostasis in 4.2%, and stent placement in 3.3%. Adverse events were observed in 103 cases (1.92%), and there were no cases of death due to endoscopic procedures. The number of pediatric patients treated by endoscopy is gradually increasing, and the same treatment as that for adults is now being performed in many cases. The present review summarizes the gastrointestinal endoscopic treatment for pediatric patients.