The safety of aerodigestive tract flexible endoscopy as an outpatient procedure in young children

Background: Flexible endoscopy (FE) for the pediatric aerodigestive tract is an invasive and complicated procedure; therefore, it is usually performed under an inpatient setting. We investigated whether FE could be a safe procedure for outpatient young children (< 5 years old) and analyzed the findings. Methods: Outpatient FE records were retrospectively reviewed between 1996 and 2003. Patients aged less than 5 years were enrolled and allocated to 3 age groups: group A (<= 3 months), group B (4-12 months), and group C (1-5 years). Patients with or without previously known major airway anomalies were also grouped for analysis. Results: A total of 728 children (479 boys, 249 girls) who underwent 834 FE procedures were collected. Of those without previously known airway anomalies, stridor was the most common symptom in group A (60.2%), and snoring in group B (34.1%) and group C (74.2%). Laryngomalacia was the most common FE finding in group A (60.2%) and group B (34.1%), and nasal adenoid hypertrophy in group C (69.6%). After FE, there were 57 admissions (6.8%), and higher in those aged less than 1 year or in those with major airway anomalies. Seven (0.7%) were complication-associated admissions. Conclusion: From this study, we conclude that FE is a safe, effective and tolerable outpatient procedure in the majority of young children, and serious complications were uncommon.