{"id":18348,"date":"2026-03-23T11:22:32","date_gmt":"2026-03-23T09:22:32","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=18348"},"modified":"2026-03-23T12:48:22","modified_gmt":"2026-03-23T10:48:22","slug":"endoscopia-digestiva-pediatrica-in-romania-intre-progres-universitar-si-deficit-de-specialisti","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/endoscopia-digestiva-pediatrica-in-romania-intre-progres-universitar-si-deficit-de-specialisti\/","title":{"rendered":"Endoscopia digestiv\u0103 pediatric\u0103 \u00een Rom\u00e2nia: \u00eentre progres universitar \u0219i deficit de speciali\u0219ti"},"content":{"rendered":"

Prof. univ. dr. Smaranda Diaconescu,medic primar gastroenterologie pediatric\u0103 \u0219i pediatrie, Universitatea \u201eTitu Maiorescu\u201d Bucure\u0219ti,<\/strong> atrage aten\u021bia asupra provoc\u0103rilor majore din gastroenterologia pediatric\u0103 rom\u00e2neasc\u0103: num\u0103r insuficient de speciali\u0219ti, lipsa liniilor de gard\u0103 pentru urgen\u021be endoscopice \u0219i nevoia urgent\u0103 de formare dedicat\u0103. \u00cen paralel, ini\u021biative precum conferin\u021ba dedicat\u0103 tranzi\u021biei pacientului pediatric \u0219i proiectul regional GastRO-MD Learning Days \u00ee\u0219i propun s\u0103 consolideze educa\u021bia medical\u0103 \u0219i colaborarea interdisciplinar\u0103 \u00een domeniu.<\/em><\/p>\n

Care este nivelul actual al endoscopiei digestive pediatrice \u00een Rom\u00e2nia comparativ cu alte \u021b\u0103ri europene<\/strong><\/p>\n

\u00cen Europa cele mai recente date publicate sunt din 2022, \u00een prestigioasa revist\u0103 Endoscopy International Open, \u0219i le voi trece succint \u00een revist\u0103. Este vorba de centre de formare din 19 \u021b\u0103ri (Rom\u00e2nia nu a fost inclus\u0103) care au participat la studiu. \u00cen 57 de centre, compartimentul de endoscopie a fost ata\u0219at sec\u021biilor de gastroenterologie pediatric\u0103, \u00een timp ce \u00een alte 23, endoscopiile pediatrice au fost efectuate \u00een unit\u0103\u021bi de endoscopie pentru adul\u021bi. Procedurile au fost efectuate de gastroenterologi pediatri \u00een 55 de centre, \u00een timp ce 31 de centre au raportat implicarea unui endoscopist pentru adul\u021bi \u0219i 14 a unui chirurg pediatru. Peste 90% dintre centre dispun de asistente medicale specializate \u00een endoscopie \u0219i anestezi\u0219ti pediatrici. Ca num\u0103r de proceduri (defalcat pe endoscopii superioare\/inferioare\/terapeutice) vorbim de extreme care variaz\u0103 \u00eentre 2000\/1100\/700 p\u00e2n\u0103 la 200\/50\/50.<\/p>\n

\u00cen Rom\u00e2nia endoscopia pediatric\u0103 se practic\u0103 doar \u00een centre universitare (Bucure\u0219ti, T\u00e2rgu Mure\u0219, Cluj, Timi\u0219oara, Ia\u0219i, Gala\u021bi \u0219i mai nou, la Suceava) dar dot\u0103rile sunt neuniforme, ca \u0219i resursa uman\u0103. Asta \u0219i pentru c\u0103 suntem foarte pu\u021bini la nivel na\u021bional. \u00cen centrele cu activitatea cea mai intens\u0103 se ajunge undeva pe la 500-600 de proceduri anual, poate un pic peste.\u00a0 \u00a0Cred c\u0103 cea mai mare problem\u0103 pe care o vom avea \u00een anii urm\u0103tori va fi lipsa unui personal mediu calificat, deoarece nu exist\u0103 cursuri de formare \u0219i perfec\u021bionare pentru asistente medicale. Fiecare centru face doar anumite proceduri, \u00een func\u021bie de expertiza echipei.<\/p>\n

Ce lipsuri majore a\u021bi identificat \u00een sistemul medical rom\u00e2nesc \u00een ceea ce prive\u0219te \u00eengrijirea copiilor cu afec\u021biuni digestive?<\/strong><\/p>\n

Num\u0103rul mic de speciali\u0219ti se reflect\u0103 \u00een disponibilitatea foarte sc\u0103zut\u0103 a acestora. \u0218i c\u00e2nd spun speciali\u0219ti m\u0103 refer la cei cu drept de paraf\u0103 \u00een gastroenterologia pediatric\u0103. Pentru c\u0103 in rest avem tot felul de \u201cspeciali\u0219ti\u201d \u00een orice, \u0219i nu doar la medicin\u0103. Acest num\u0103r mic face ca \u00een spitalele publice care nu sunt universitare s\u0103 nu se poat\u0103 \u00eenfiin\u021ba sec\u021bii dedicate, cel mult compartimente, cel mult mai g\u0103sim c\u00e2te un medic angajat \u00een ambulatoriu. Evident c\u0103 asta este extrem de frustrant pentru p\u0103rin\u021bii care se v\u0103d nevoi\u021bi s\u0103 mearg\u0103 sute de kilometri uneori pentru a beneficia de o consulta\u021bie de specialitate, \u00een regim gratuit, \u00eentr-o unitate sanitar\u0103 public\u0103. Eu nu cred c\u0103 viitorul mai apar\u021bine acelor sec\u021bii \u201cmamut\u201dde pediatrie cum existau pe vremuri, ci unor sec\u021bii mai mici, cu compartimente specializate \u0219i cu accent maxim pe ambulatoriu \u0219i spitalizarile de zi. Pentru ce s\u0103 te internezi cu copilul c\u00e2nd po\u021bti face o ecografie \u0219i analize \u00een policlinic\u0103? \u00cens\u0103, aici situa\u021bia este un pic ingrat\u0103, pentru ca ambulatoriul s\u0103 func\u021bioneze \u00een mod real ar trebui debirocratizat, pentru c\u0103 niciun pacient nu va alege s\u0103 ia trimitere de la medicul de familie, apoi s\u0103 fac\u0103 programare online, s\u0103 a\u0219tepte programarea, apoi eventual s\u0103 fac\u0103 alta pentru investiga\u021bii. Mai ales \u00een pediatrie, unde p\u0103rin\u021bii intr\u0103 \u00een panic\u0103 foarte repede \u0219i acceseaz\u0103 serviciile de urgen\u021b\u0103 unde primesc toate aceste servicii (inclusiv consult de specialitate) \u00eentr-un timp record de\u0219i de cele mai multe ori nu este vorba de o patologie real\u0103 de urgen\u021b\u0103. Pentru panic\u0103 \u00eens\u0103 nu exist\u0103 \u201ctratament\u201d. Doar educa\u021bie medical\u0103 continu\u0103 \u0219i sus\u021binut\u0103 adresat\u0103 familiilor pe care trebuie s\u0103 o facem fiecare dintre noi, \u00eencep\u00e2nd chiar cu anii de studen\u021bie. Rezum\u00e2nd, sistemul public \u00ee\u0219i face \u00eentr-o anumit\u0103 m\u0103sur\u0103 concuren\u021b\u0103 singur, a\u0219a cum remarca o prieten\u0103 de-a mea, medic, cu care am avut aceast\u0103 discu\u021bie \u0219i c\u0103reia \u00eei mul\u021bumesc.<\/p>\n

Ce ar fi esen\u021bial de \u00eembun\u0103t\u0103\u021bit pentru a forma mai mul\u021bi speciali\u0219ti \u00een acest domeniu?<\/strong><\/p>\n

Din p\u0103cate, de\u0219i cererea este foarte mare, oferta de speciali\u0219ti este foarte mic\u0103. Am analizat informa\u021biile de oferite de \u00a0https:\/\/blog.grile-rezidentiat.ro\/<\/a>, un site dedicat informa\u021biilor despre reziden\u021biat \u0219i am v\u0103zut c\u0103 evolu\u021bia preferin\u021belor pentru aceast\u0103 specialitate \u00eentre 2018 \u0219i 2025 a fost de la locul 64 \u00een 2018, 47 \u00eentre\u00a0 2019-2021, 45 \u00een 2022, 57 \u00een 2023 \u0219i 2024 \u0219i pozi\u021bia 49 \u00een 2025. Iar \u00een 2025 doar 2 (doi!) dintre candida\u021bii care au r\u0103spuns la sondaj au avut ca prim\u0103 op\u021biune aceast\u0103 specialitate. Adic\u0103 situa\u021bia nu este roz deloc, gastroenterologia pediatric\u0103 este \u00een continuare specialitate deficitar\u0103. Poate c\u0103 ar fi bun\u0103 \u0219i o campanie de imagine, poate c\u0103 studen\u021bii nu prea \u00een\u021beleg cu ce \u201cse m\u0103n\u00e2nc\u0103\u201d specialitatea asta \u0219i c\u00e2t de multe lucruri po\u021bi face ca gastroenterolog pediatru. Este adev\u0103rat c\u0103 sunt pediatri care aleg s\u0103 fac\u0103 al doilea rezidentiat dar asta nu \u00eenseamn\u0103 c\u0103 sistemul public va avea speciali\u0219ti. \u0218i spun acest lucru pentru c\u0103 mare parte dintre ei deja sunt \u00eencadra\u021bi ca pediatri generali\u0219ti \u0219i vor practica gastroenterologia pediatric\u0103 \u00een privat. Iar pentru p\u0103rin\u021bi asta nu este neap\u0103rat o veste bun\u0103, toat\u0103 lumea dore\u0219te s\u0103 beneficieze de gratuitate prin sistemul public de asigur\u0103ri de s\u0103n\u0103tate. A\u0219a cum spuneam, lipsa unei predictibilit\u0103\u021bi a traseului profesional este clar un factor care contribuie la un interes sc\u0103zut al absolven\u021bilor pentru aceast\u0103 specialitate. Poate c\u0103 ar trebui s\u0103 facem mai multe cursuri postuniversitare, acestea nu vor oferi, de exemplu, dreptul de a face endoscopie dar ar reprezenta o oportunitate de perfec\u021bionare \u0219i de oferire c\u0103tre popula\u021bie a unor servicii medicale mai bune. Pentru c\u0103 prea de multe ori am remarcat c\u0103 toata lumea se pricepe la tot, ceea ce nu este chiar a\u0219a. Dac\u0103 n-ai facut niciun atestat, supraspecializare ori specialitate nu cred c\u0103 po\u021bi furniza o opinie pertinent\u0103 \u0219i un diagnostic de fine\u021be. Poate c\u0103 la un moment dat va fi reluat\u0103 \u0219i formarea de endoscopi\u0219ti prin intermediul atestatului de studii complementare.<\/p>\n

Care considera\u021bi c\u0103 sunt priorit\u0103\u021bile imediate pentru optimizarea practicii de endoscopie digestiv\u0103 pediatric\u0103 \u00een prezent?<\/strong><\/p>\n

M\u0103 tem c\u0103 ce am spus acum doi ani este valabil \u0219i acum. Nu exist\u0103 linie de gard\u0103 pe urgen\u021be endoscopice nic\u0103ieri. Mac\u0103r una per regiune istoric\u0103 dac\u0103 ar fi \u0219i tot ar fi un pas \u00eenainte. Poate c\u0103 nu sunt cazuri \u00een fiecare noapte. Dar sunt nop\u021bi cu c\u00e2te 3 sau 4 ingestii de corp str\u0103in. \u0218i atunci, dac\u0103 po\u021bi salva niste copii de la fistule, de la perfora\u021bii, de la interven\u021bii chirurgicale \u0219i chiar de la deces, cum s\u0103 nu faci asta? Nici m\u0103car n-ar fi foarte complicat din punct de vedere logistic, \u00een fiecare regiune sunt centre \u00een care se practic\u0103 endoscopia terapeutic\u0103, azi pui gard\u0103 \u00eentr-un centru, m\u00e2ine \u00een altul, etc. \u00ce\u021bi trebuie maximum 100 de oameni la nivel na\u021bional care s\u0103 fac\u0103 o gard\u0103 din asta pe lun\u0103. Nu mi se pare de nerealizat av\u00e2nd \u00een vedere c\u0103 s-au format deja ni\u0219te speciali\u0219ti \u0219i mai sunt \u0219i cei din garda veche. Pentru c\u0103 acum, c\u00e2nd un copil \u00eenghite ceva scriu mamele disperate pe social-media c\u0103 nu \u0219tiu unde s\u0103 se duc\u0103 cu el sau se duc \u0219i nu e gard\u0103.<\/p>\n

Sper s\u0103 nu ies la pensie \u00eenainte ca lucrurile s\u0103 intre \u00een normal. Despre lipsa acut\u0103 de personal mediu cu care ne vom confrunta am vorbit deja.<\/p>\n

V\u0103 rog s\u0103 ne oferi\u021bi informa\u021bii cu privire la proiectele profesionale \u00een care sunte\u021bi implicat\u0103 anul acesta, \u0219i m-a\u0219 referi aici \u0219i la GastRO-MD Learning Days, dar \u0219i a doua edi\u021bie a Conferin\u021bei Na\u021bionale Tranzi\u021bia pacientului pediatric c\u0103tre serviciile de s\u0103n\u0103tate dedicate adul\u021bilor. Ce \u00ee\u0219i propun aceaste dezbateri?<\/strong><\/p>\n

Voi \u00eencepe prin a spune c\u0103 ambele proiecte se desf\u0103\u0219oar\u0103 sub egida Societ\u0103\u021bii Rom\u00e2ne de Pediatrie, condus\u0103 de D-na Profesor Doina Ple\u0219ca.<\/p>\n

M\u0103 voi referi \u00eent\u00e2i la \u201ctranzi\u021bie\u201d pentru c\u0103 aici suntem la edi\u021bia a doua, care va avea loc la Bucure\u0219ti \u00een data de 22 aprilie. Este vorba, a\u0219a cum arat\u0103 \u0219i numele, de o conferin\u021b\u0103 dedicat\u0103 problemelor pe care le \u00eent\u00e2mpin\u0103 un pacient pediatric cu o boal\u0103 cronic\u0103 dar \u0219i familia acestuia. P\u0103rin\u021bii \u0219i copiii se trezesc \u00eentr-un univers complet nou, cu o sumedenie de \u00eentreb\u0103ri \u0219i dificult\u0103\u021bi. Prima edi\u021bie de anul trecut a st\u00e2rnit un interes foarte mare, am avut 5200 de participan\u021bi on line, din absolut toate specialit\u0103\u021bile de copii \u0219i adul\u021bi \u0219i din toat\u0103 \u021bara. Au fost dou\u0103 zile foarte pline. Anul acesta ne vedem fa\u021b\u0103 \u00een fa\u021b\u0103 \u0219i relu\u0103m dezbaterile, ne propunem de exemplu s\u0103 avem prezent\u0103ri care s\u0103 se refere la bunele practici de tranzi\u021bie pentru medici \u0219i al\u021bi profesioni\u0219ti din domeniul s\u0103n\u0103t\u0103\u021bii interesa\u021bi. Tranzi\u021bia \u00eenseamn\u0103 preg\u0103tirea pacientului, a familiei \u0219i a personalului medical. \u00cencepem cu aces\u021bia din urm\u0103, apoi..vedem. Eu cred c\u0103 programe educa\u021bionale ar trebui oferite pe scar\u0103 larg\u0103, c\u0103 p\u00e2n\u0103 la urm\u0103 \u0219i dac\u0103 vorbim de copii cu patologii uzuale..cine \u00eei \u00eenva\u021b\u0103 cum s\u0103-\u0219i autogestioneze s\u0103n\u0103tatea dup\u0103 v\u00e2rsta de 18 ani?<\/p>\n

GastRO-MD Learning Days este un proiect pilot, un proiect regional adresat medicilor preocupa\u021bi de s\u0103n\u0103tatea digestiv\u0103 a copiilor, adolescen\u021bilor \u0219i adul\u021bilor tineri din Rom\u00e2nia \u0219i Republica Moldova. Am spus c\u0103 este un proiect regional deoarece se va desf\u0103\u0219ura \u00een Bucovina, la Gura Humorului \u00een perioada 31 iulie – 2 august, pentru a \u00a0sublinia deschiderea endoscopiei digestive pediatrice la Suceava. Ne-am g\u00e2ndit la subiecte extrem de diverse precum refluxul gastroesofagian, esofagita eozinofilic\u0103, infec\u021bia cu Helicobacter pylori<\/em>, boala celiac\u0103, tulbur\u0103rile func\u021bionale digestive, boala inflamatorie intestinal\u0103, hepatitele cronice, transplantul hepatic, patologie pancreatic\u0103 \u0219i biliar\u0103, constipa\u021bia cronic\u0103, actualit\u0103\u021bi legate de microbiota intestinal\u0103, biomarkerii fecali, utilitatea practic\u0103 a testelor respiratorii \u00een explorarea afec\u021biunilor digestive, precum \u0219i la demonstra\u021bii practice \u0219i ateliere hands-on de endoscopie digestiv\u0103 diagnostic\u0103, terapeutic\u0103 \u0219i ecografie. Nu \u00een ultimul r\u00e2nd, vor fi abordate concepte moderne precum psihogastroenterologia, rolul AI \u00een gastroenterologie, precum \u0219i alte nout\u0103\u021bi incitante. Sper\u0103m ca acest program, sus\u021binut de lectori de excep\u021bie s\u0103 fie bine primit de c\u00e2t mai mul\u021bi medici speciali\u0219ti \u0219i reziden\u021bi.<\/p>\n

\u00cen \u00eencheiere v\u0103 rog s\u0103 transmite\u021bi un mesaj comunit\u0103\u021bii academice \u0219i clinice interesate de gastroenterologia pediatric\u0103?<\/strong><\/p>\n

Cred c\u0103 tot ce am spus mai sus ar putea fi considerat un mesaj. Sper s\u0103 fie \u0219i auzit.<\/p>\n","protected":false},"excerpt":{"rendered":"

Prof. univ. dr. Smaranda Diaconescu,medic primar gastroenterologie pediatric\u0103 \u0219i pediatrie, Universitatea \u201eTitu Maiorescu\u201d Bucure\u0219ti, atrage aten\u021bia asupra provoc\u0103rilor majore din gastroenterologia pediatric\u0103 rom\u00e2neasc\u0103: num\u0103r insuficient de speciali\u0219ti, lipsa liniilor de […]<\/p>\n","protected":false},"author":1,"featured_media":18357,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[276],"tags":[],"class_list":["post-18348","post","type-post","status-publish","format-standard","has-post-thumbnail","category-interviu"],"yoast_head":"\nEndoscopia digestiv\u0103 pediatric\u0103 \u00een Rom\u00e2nia: \u00eentre progres universitar \u0219i deficit de speciali\u0219ti - Jurmed - Medici<\/title>\n<meta name=\"description\" content=\"Endoscopia digestiv\u0103 pediatric\u0103\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/endoscopia-digestiva-pediatrica-in-romania-intre-progres-universitar-si-deficit-de-specialisti\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Endoscopia digestiv\u0103 pediatric\u0103 \u00een Rom\u00e2nia: \u00eentre progres universitar \u0219i deficit de speciali\u0219ti - 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