Reliability Of Different Endoscopic Classification Systems In Predicting Pediatric Reflux Esophagitis

Authors : Halil Haldun EMİROĞLU, Özlem DURMAZ, Semra SÖKÜCÜ`

Pages : 280-284

View : 21 | Download : 9

Publication Date : 2019-12-10

Article Type : Conference Paper

Abstract :Aim: Retrospective in nature, this study was aimed at evaluating the reliability of four endoscopic classification systems in predicting histological reflux esophagitis in children undergoing esophagogastroduedenoscopy. Materials and Methods: This retrospective study included 213 children insert ignore into journalissuearticles values(112 male, 101 female, average age 8.4 ± 4.8 years, median age 9 years, range 2 months–18 years); who underwent diagnostic esophagogastroduodenoscopy between January 2002 and December 2004 and evaluated for the presence of reflux esophagitis. Data for age and gender, and detailed endoscopic and histopathological reports were retrieved from medical records. Los Angeles, Savary-Miller, Hetzel-Dent, and Tytgat endoscopic classification systems were used in the evaluation of patients with erosive distal esophagitis. The histological findings were classified according to Knuff & Leape. When reflux-related esophageal damage was identified as a result of the histological examination of endoscopic biopsy samples collected from distal esophagus, the patients were diagnosed with reflux esophagitis. The Statistical Package for the Social Sciences for Windows Release 12.0 insert ignore into journalissuearticles values(SPSS, Chicago, IL, USA); was used to analyse the statistical data. Results: On the histological examination of esophageal mucosal biopsy specimens of 213 patients, 71 insert ignore into journalissuearticles values(33.3%); patients had normal insert ignore into journalissuearticles values(grade 0);, 75 insert ignore into journalissuearticles values(35.2%); patients with only histologic changes of reflux insert ignore into journalissuearticles values(grade 1); without esophagitis and 67 insert ignore into journalissuearticles values(31.5%); patients were reflux esophagitis insert ignore into journalissuearticles values(grade 2–5); were detected. There were 49 insert ignore into journalissuearticles values(23%); patients with mild esophagitis insert ignore into journalissuearticles values(grade 2);, 6 insert ignore into journalissuearticles values(3%); patients with moderate esophagitis insert ignore into journalissuearticles values(grade 3); and 12 insert ignore into journalissuearticles values(6%); patients with severe esophagitis 2 insert ignore into journalissuearticles values(1%); patients with grade 4 and 10 insert ignore into journalissuearticles values(5%); patients with grade 5); in 67 patients with reflux esophagitis. On the endoscopical examination of esophageal mucosal appearances of 213 patients, 36 insert ignore into journalissuearticles values(16.9%); patients, 36 insert ignore into journalissuearticles values(16.9%); patients, 100 insert ignore into journalissuearticles values(46.9%); patients and 90 insert ignore into journalissuearticles values(42.3%); patients were diagnosed with esophagitis according to the Los Angeles, Savary-Miller, Hetzel-Dent and Tytgat endoscopic classification systems, respectively. When the four different endoscopic classification systems evaluated in terms of score correlation with the histological diagnosis, the most linear relationship was found between LA endoscopic classification and Knuff & Leape histological classification insert ignore into journalissuearticles values(r = 0.544, p <0.01);. Conclusion: No significant strong association in the prevalence of reflux esophagitis between the endoscopic classification systems and Knuff & Leape histological classification. The Los Angeles endoscopic classification more compatible with Knuff & Leape histological classification than other endoscopic classification systems. Though not so safe, the Los Angeles endoscopic classification can be recommended in children as in adults.
Keywords : Gastroesophageal reflux disease