Читать книгу Practical Pediatric Gastrointestinal Endoscopy - Группа авторов - Страница 27

Pediatric patients often have limitations in therapy due to size and approved measures. Endoscopic equipment can be purchased used or new or leased for a predetermined amount of time.

Purchasing or leasing endoscopy equipment represents a significant capital budget item for any setting in which pediatric endoscopy will be performed. Fewer endoscopes may be necessary to run concurrent rooms in smaller centers, compared with larger centers that feature more endoscopists and more endoscopy rooms. There are no data to guide how many scopes should be on hand at any endoscopy unit. To maximize efficiency, one light source and processor should be available per endoscopy room and one scope reprocessor allocated for each 1000 procedures per year. For adult units, one colonoscope and gastroscope per 350 procedures per year has been suggested as ideal [4], but this general recommendation may not apply to pediatric endoscopy in which there may be a need for endoscopes of various diameters and sizes to accommodate infants and children. The frequency of endoscope upgrades is also a major factor in determining how many endoscopes should be purchased. In a recent survey, most centers reported replacing the endoscopes every 6–7 years [1].

An ideal endoscopy unit offers diagnostic endoscopy, including capsule endoscopy, small bowel enteroscopy, pH impedance testing, and motility testing. Therapeutic endoscopy should be available at pediatric centers or offered by an adult gastroenterologist in the area. If trained endoscopy staff are not always available to participate in emergent cases, having specific toolkits such as a bleeding or foreign body removal kit can ensure that correct endoscopic accessories are available.