E0436 - Safety and Efficacy of Pediatric Endosonography: A Multi-Center Retrospective Cohort Study

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Karl Akiki, MD

Mayo Clinic
Rochester, MN

Karl Akiki, MD¹, Andrew Canakis, DO², Tala Mahmoud, MD¹, Mohammad H. Alqaisieh, MD¹, Barham Abu Dayyeh, MD, MPH¹, Vinay Chandrasekhara, MD¹, Ryan Law, DO¹, Michael J. Levy, MD¹, John A. Martin, MD¹, Bret T Petersen, MD¹, Eric J. Vargas, MD, MS¹, Ferga C. Gleeson, MB, BCh, BAO¹, Elizabeth Rajan, MD¹, Aliana M. Bofill-Garcia, MD¹, Sara Hassan, MD¹, Raymond E. Kim, MD³, Andrew C. Storm, MD¹
¹Mayo Clinic, Rochester, MN; ²University of Maryland Medical Center, Baltimore, MD; ³University of Maryland School of Medicine, Baltimore, MD

Introduction: Endoscopic ultrasound (EUS) is widely used in the adult population for a wide range of diagnostic and therapeutic purposes. In the pediatric population, the use of EUS has been historically diagnostic, however, EUS-guided therapy is increasing. In this retrospective study, we aim to describe the safety and efficacy profiles of EUS in pediatric patients across a spectrum of EUS procedures.

Methods: This is a retrospective multi-center cohort study of pediatric patients who underwent EUS procedures for diagnostic or therapeutic purposes between January 2011 and March 2022. Data including demographics, procedural details, and adverse events (AE) were collected. Outcomes were diagnostic success, defined as successful diagnosis using only EUS without any additional diagnostic tools, and therapeutic success, defined as using only EUS without additional therapeutic interventions.

Results: 61 pediatric patients between the age of 0 to 18 years underwent 77 EUS procedures, of which 35 were females (56.5%). The mean age at the procedure was 16.2 ± 4.2 years and the median weight was 70.2 kg (IQR 49.7-91.2). The indications for EUS were gastrointestinal lumen evaluation ± fine needle biopsy/aspiration (FNB/A), pancreaticobiliary tree evaluation ±FNB/A, surveillance for tumor syndrome, suspected lymph node (LN), or gastrointestinal (GI) mass, celiac plexus block and cyst gastrostomy creation (Table 1). The median procedure time was 35 minutes (IQR 18 – 49). The diagnostic success rate was 98.7% and the therapeutic success rate was 100%. The complication rate was 2.6% which included 2 cases of pancreatitis after fine-needle aspiration of the pancreas. No case had any anesthesia-related complications.

Discussion: In this multicenter retrospective cohort study, the use of EUS in pediatrics has shown to be safe and effective in a wide range of diagnostic and therapeutic intents.

	N=77 (%)
Females	35 (56.5)
Weight (n=66)	70.2 [49.7 – 91.2]
Age at procedure (years)	16.2 ± 4.2
Indication
Diagnostic
GI lumen Evaluation	9 (11.7)
GI lumen Evaluation with FNB/A	5 (6.5)
Pancreaticobiliary tree evaluation	37 (48.1)
Pancreaticobiliary tree evaluation with FNB/A	6 (7.8)
Surveillance for tumor syndrome	7 (9.1)
Suspected LN or mass	8 (10.4)
Therapeutic
Celiac Plexus Block	1 (1.3)
Cystgastrostomy	4 (5.2)
Anesthesia Type
Monitored Anesthesia Care (MAC)	48 (62.3)
General Anesthesia	29 (37.7)
Mean procedure Time in minutes (N= 59)	35.0 [18.0 - 49.0]
Diagnostic Success	76 (98.7)
Therapeutic Success (n=5)	5 (100)
EUS related complications	2 (2.6)
Anesthesia complications	0 (0)
EUS = endoscopic ultrasound, FNA/B = fine needle aspiration/biopsy, LN = lymph node Continuous variables presented as mean ± SD or median (IQR) Categorical variables presented as n (%)

Table: Table 1- Baseline characteristics, procedural and clinical outcomes of pediatric patient EUS procedures.

Disclosures:

Karl Akiki indicated no relevant financial relationships.

Andrew Canakis indicated no relevant financial relationships.

Tala Mahmoud indicated no relevant financial relationships.

Mohammad Alqaisieh indicated no relevant financial relationships.

Barham Abu Dayyeh: Apollo Endosurgery – Grant/Research Support. Aspire Bariatrics – Grant/Research Support. BFKW – Consultant. Boston Scientific – Consultant, Grant/Research Support. Cairn Diagnostics – Grant/Research Support. DyaMx – Consultant. Endogastric Solutions, – Speakers Bureau. Endo-TAGSS – Consultant. GI Dynamics – Grant/Research Support. Johnson and Johnson – Speakers Bureau. Medtronic; – Grant/Research Support. Metamodix – Consultant. Olympus – Speakers Bureau. Spatz Medical – Grant/Research Support. USGI Medical – Consultant, Grant/Research Support.

Vinay Chandrasekhara: Boston Scientific – Consultant. Covidien, LP – Consultant. Nevakar Corporation – Stock-privately held company.

Ryan Law: Boston Scientific – Consultant. ConMed – Consultant. Medtronic – Consultant. Olympus – Consultant. UpToDate – Royalties.

Michael Levy indicated no relevant financial relationships.

John Martin indicated no relevant financial relationships.

Bret T Petersen: AMBU – Grant/Research Support. Boston scientific – Grant/Research Support. Olympus – Consultant.

Eric Vargas indicated no relevant financial relationships.

Ferga Gleeson indicated no relevant financial relationships.

Elizabeth Rajan: Medtronic – Intellectual Property/Patents. Olympus – Consultant.

Aliana Bofill-Garcia indicated no relevant financial relationships.

Sara Hassan indicated no relevant financial relationships.

Raymond Kim: Cook Medical – Consultant. Metronic – Consultant.

Andrew Storm: Apollo Endosurgery – Consultant. Apollo Endosurgery – Grant/Research Support. Boston Scientific – Grant/Research Support. Endo-TAGSS – Grant/Research Support. Enterasense – Consultant. ERBE – Consultant. GI Dynamics – Consultant. Olympus – Consultant.