Liu Bo, Zhang Hui-Hua, Zhang Hui-Hui, Fang Hao-Ran, Hu Hua-Jian, Li Zhong-Yue
Department of Gastroenterology/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics/Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Apr 15;24(4):354-359. doi: 10.7499/j.issn.1008-8830.2111125.
To study the clinical features of children with colorectal polyps and the efficacy of endoscopic treatment.
A retrospective analysis was performed on the medical data of 1 351 children with colorectal polyps who were admitted and received colonoscopy and treatment in the past 8 years, including clinical features and the pattern and outcomes of endoscopic treatment.
Among the 1 351 children, 893 (66.10%) were boys and 981 (72.61%) had an age of 2-<7 years, and hematochezia (1 307, 96.74%) was the most common clinical manifestation. Of all the children, 89.27% (1 206/1 351) had solitary polyps, and 95.77% (1 290/1 347) had juvenile polyps. The polyps were removed by electric cauterization with hot biopsy forceps (6 cases) or high-frequency electrotomy and electrocoagulation after snare ligation (1 345 cases). A total of 1 758 polyps were resected, among which 1 593 (90.61%) were pedunculated and 1 349 (76.73%) had a diameter of <2 cm. Postoperative complications included bleeding in 51 children (3.77%), vomiting in 87 children (6.44%), abdominal pain in 14 children (1.04%), and fever in 39 children (2.89%), while no perforation was observed. The children aged <3 years had the highest incidence rates of postoperative bleeding and fever (<0.0125), and the children with a polyp diameter of ≥2 cm had significantly higher incidence rates of postoperative bleeding, vomiting, and fever (<0.05).
Solitary polyps, pedunculated polyps, and juvenile polyps are common types of pediatric colorectal polyps. Electric cauterization with hot biopsy forceps or high-frequency electrotomy and electrocoagulation after snare ligation can effectively remove colorectal polyps in children, with good efficacy and few complications. Younger age and larger polyp diameter are associated with a higher risk of postoperative bleeding.
研究儿童大肠息肉的临床特征及内镜治疗效果。
回顾性分析过去8年收治并接受结肠镜检查及治疗的1351例儿童大肠息肉患者的病历资料，包括临床特征、内镜治疗方式及治疗结果。
1351例患儿中，男893例（66.10%），年龄2～<7岁者981例（72.61%），便血（1307例，96.74%）为最常见临床表现。所有患儿中，89.27%（1206/1351）为单发息肉，95.77%（1290/1347）为幼年性息肉。采用热活检钳电灼切除息肉6例，圈套器套扎后高频电切电凝切除息肉1345例。共切除息肉1758枚，其中有蒂息肉1593枚（90.61%），直径<2 cm的息肉1349枚（76.73%）。术后并发症包括出血51例（3.77%）、呕吐87例（6.44%）、腹痛14例（1.04%）、发热39例（2.89%），未观察到穿孔病例。<3岁患儿术后出血和发热发生率最高（<0.0125），息肉直径≥2 cm的患儿术后出血、呕吐和发热发生率显著更高（<0.05）。
单发息肉、有蒂息肉和幼年性息肉是儿童大肠息肉的常见类型。热活检钳电灼或圈套器套扎后高频电切电凝可有效切除儿童大肠息肉，疗效好且并发症少。年龄较小和息肉直径较大与术后出血风险较高相关。
