Training in pediatric neurogastroenterology and motility across Europe: a survey of the ESPGHAN National Societies Network 2016-2019

Abstract

Background: Pediatric gastrointestinal motility disorders present significant challenges for diagnosis and management, emphasizing the need for appropriate training in Pediatric Neurogastroenterology and Motility (PNGM). The aim of this survey, part of a comprehensive survey on training in pediatric gastroenterology, hepatology and nutrition, was to evaluate training related to PNGM across European training centers.

Method: Standardized questionnaires were collected from training centers through the National Societies Network of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), from June 2016 to December 2019.

Results: In total, 100 training centers from 19 countries participated in the survey. Dedicated PNGM clinics were available in 22 centers; pH-monitoring in 60; pH/impedance in 66; standard manometry in 37; and high-resolution manometry in 33. If all motility studies were performed partially or fully by the trainees, the median (range) annual numbers/per trainee were as follows: pH-monitoring 30 (1-500); pH/impedance 17 (1-131); standard manometries 10 (1-150); and high-resolution manometries 8 (1-75). The motility assessment was performed by pediatric gastroenterologists (43 centers); adult gastroenterologists (10 centers); pediatric surgeons (5 centers); and both pediatric gastroenterologists and pediatric surgeons (9 centers). Annual numbers ≤10 for pH-monitoring, pH/impedance, standard manometries and high-resolution manometries were reported by 7 (12%), 15 (23%), 11 (30%) and 14 (42%) centers, respectively.

Conclusions: Significant differences exist in PNGM-related infrastructure, staff and procedural volumes at training centers across Europe. ESPGHAN and the National Societies should take initiatives to ensure the acquisition of competence in PNGM-related knowledge and skills, and develop strategies for assessment and accreditation.An infographic is available for this article at: http://www.annalsgastro.gr/files/journals/1/earlyview/2022/Infographic-AG6486.pdf.

Keywords: Gastrointestinal motility training; children; hepatology and nutrition; training in pediatric gastroenterology.

Figure 1

The annual number of pH impedance studies performed by the participating in the survey training centers with the largest procedural volume in each country. The centers shown in the figure are the following: Rome (Department of Pediatrics, Sapienza University, Rome, Italy); Bristol (Bristol Children’s Hospital , Bristol, UK); Athens (Children’s hospital Agia Sofia, Athens, Greece); Madrid (Niño Jesús University Hospital, Madrid, Spain); Brussels (Saint-Luc University Hospital, Brussels, Belgium); Maribor (University Medical center, Maribor, Slovenia); Graz (Department of Pediatrics, Medical University of Graz, Graz, Austria); Zagreb (Children’s Hospital Zagreb, Zagreb, Croatia); Ulm (University Medical Centre, Ulm, Germany), Varna (Saint Marina University hospital, Varna, Bulgaria); Petah Tiqva (Schneider Children’s Medical Center of Israel, Petah Tiqva, Israel); Lausanne (Lausanne University Hospital, Lausanne, Switzerland); Amsterdam (Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands); Prague (Department of Pediatrics, University Hospital Motol, Prague, Czech Republic); Porto (Centro Hospitalar de São João, Porto, Portugal); Debrecen (University Children’s Hospital, Debrecen, Hungary); Lille (Lille University Hospital, Lille, France); Malatya (Inönü University Faculty of Medicine, Malatya, Turkey)

Figure 2

The annual number of high-resolution manometry studies performed by the participating in the survey training centers with the largest procedural volume in each country. The centers shown in the figure are the following: London (Great Ormond Street hospital, London, UK); Lille (Lille University Hospital, Lille, France); Brussels (Queen Fabiola University Children’s Hospital, Libre University, Brussels, Belgium); Rome (Bambino Gesù Children’s Hospital, Rome, Italy), Zagreb (University Hospital Center Zagreb, Zagreb, Croatia); Graz (Department of Pediatrics, Medical University of Graz, Graz, Austria); Seville (Hospital Infantil Virgen Del Rocio, Seville, Spain); Athens (Children’s hospital Agia Sofia, Athens, Greece); Petah Tiqva (Schneider Children’s Medical Center of Israel, Petah Tiqva, Israel); Amsterdam (Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands); Lucerne (Children’s Hospital of Lucerne, Lucerne, Switzerland); Prague (Department of Pediatrics, University Hospital Motol, Prague, Czech Republic); Ulm (University Medical Centre Ulm, Ulm, Germany)

Figure 3

Annual number of pH/impedance and pH-monitoring studies per 100,000 inhabitants 0-19 years of age [9] in the countries with full representation of the training centers

Figure 4

Annual number of high-resolution manometries and standard manometries per 100,000 inhabitants 0-19 years of age [9] in the countries with full representation of training centers