The current status of pediatric endoscopy in Italy: a national survey

Background: The number and the features of pediatric endoscopy centers in Italy are unknown. Objectives: The aim of this study is to assess the current status of pediatric endoscopy in Italy and to evaluate number and characteristics of centers performing endoscopy in children. Methods: A survey-based study was designed using a web-based multi-item questionnaire. Centers performing pediatric endoscopy were invited to participate via an invitation e-mail sent to all the members of Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP). The survey was composed of 28 questions. Main topics were: number of endoscopists per center, number of endoscopies per year and main indications, sedation techniques and suggestions to improve quality of pediatric endoscopy. Results: 26 centers submitted complete responses. In 17 (65%) centers endoscopies were performed by a pediatrician, whereas in 9 (35%) by an adult endoscopist. The number of endoscopies per center per year ranged from 20 to 2000 (median 200). The median number of procedures was 152 for upper endoscopy (range:20–1600) and 60 for colonoscopy (range: 0–700). The main indication for gastroscopy resulted Celiac disease (78%) whereas colonoscopy was mainly performed to rule out inflammatory bowel diseases (64%). In 79% of cases deep sedation was guaranteed by an anesthetist. Most of the operators suggested consensus guidelines and training programs. Conclusions: Data from this survey reveal a large variability between centers in Italy. In one third of them pediatric endoscopy is performed by an adult endoscopist. More resources are needed to improve standard of pediatric endoscopy in Italy.