Mo1988 THE PEDIATRIC ENDOSCOPY PRACTICE IN EUROPE: PRELIMINARY RESULTS OF A WEB-BASED SURVEY ON BEHALF OF THE ENDOSCOPY SPECIAL INTEREST GROUP OF EUROPEAN SOCIETY OF GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION (ESPGHAN)

The importance of ensuring quality in endoscopy is now widely supported, however, there are no formal European consensus guidelines on this topic in children. We aimed to examine current practices within European pediatric endoscopy units as a starting point for future assessments of quality and accreditation programs on behalf of ESPGHAN. A survey-based study was designed using a web-based multi-item questionnaire. Centers performing pediatric endoscopy were invited to participate via an e-mail. Initially the survey was completed by members of the ESPGHAN Endoscopy Group as a discovery cohort, the results of which are presented here. On this basis, the survey will be sent to all ESPGHAN members as a validation cohort. Thirty-eight centers from 13 countries submitted complete responses with a median of 2 full-time equivalent physicians per program (range 1-12), representing a total of 27,931 endoscopic procedures (median 550 procedures/center/year, IQR: 285-982,5). In 32 (84%) endoscopies are performed by a pediatric gastroenterologist, whereas in the remainings by pediatric surgeons, and very rarely by adult GIs (2.6%). Endoscopy is performed in a dedicated pediatric endoscopy room in 49% and with the assistance of anesthesiologists in 92%. An official fellowship program is available in 65%, with a median of 1 fellow/unit (range 1-15) performing on average 30% of the total procedures. The median number of procedures/year is 400 for upper GI endoscopy (IQR: 200-680,25), 150 for lower GI endoscopy (IQR: 50-200) and 50 for therapeutic procedure (IQR: 25-100). The main indication for upper GI endoscopy was celiac disease (41%), whereas lower GI endoscopy was mainly performed for IBD (92%). The most frequent therapeutic procedure was PEG tube placement (49%). An emergency endoscopy service (24/7) is available in 69%, while in the remaining, network services or partial services are provided. In 10% an emergency service is lacking. Participants highlighted as resources to further improve their practice: more endoscopic tools, dedicated pediatric endoscopy room and higher availability of anesthesiologists. According to the median number of procedures, we defined 19 units as large (LU) and 19 as small (SU) (Table 1). The main differences consist of the number of operators, availability of emergency service, number of exams/operator/year (especially for lower GI endoscopies) (p<0.05). (Table 1). Most of the operators suggested consensus guidelines and specific European training programs to improve quality of endoscopy. These preliminary data demonstrate a large variability between centers in Europe, especially in comparing larger with smaller units. More resources are needed to improve the quality of pediatric procedures and a specific program is necessary to standardize endoscopy in children all over Europe.