Zhou L Q, Lou J G, Zhao H, Peng K R, Luo Y Y, Yu J D, Fang Y H, Chen J
Department of Gastroenterology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
Zhonghua Er Ke Za Zhi. 2022 Jul 2;60(7):666-670. doi: 10.3760/cma.j.cn112140-20211201-01011.
To explore the incidence and the risk factors of post-polypectomy bleeding and polyp recurrence after colonoscopic high-frequency electrocoagulation snare polypectomy. Clinical data of 1 826 children who underwent colonoscopic high-frequency electrocoagulation snare polypectomy in the Children's Hospital, Zhejiang University School of Medicine from January 2009 to December 2020 was retrospectively analyzed. Demographic characteristics, endoscopic manifestations, pathological features, diagnosis, occurrence of post-polypectomy bleeding and polyp recurrence were collected. The associated risk factors were analyzed by Logistic regression. A total of 1 826 children (1 191 males and 635 females) with 1 967 polypectomies were included. The age was 4.6 (3.2, 6.4) years at initial diagnosis. According to the initial colonoscopy, 1 611 children (88.2%) had solitary polyps, 1 707 children (93.5%) had pedicled polyps, 1 151 children (63.0%) had polyps involving the rectum, and 1 757 children (96.2%) had hamartomatous polyps. Polyposis syndromes were diagnosed in 73 children (4.0%). The post-polypectomy bleeding occurrence was 3.8% (75/1 967). Polyps recurred in 88 children (4.8%). Girls (=2.01, 95% 1.26-3.23) and sessile polyps (=2.28, 95% 1.15-4.49) were risk factors for post-polypectomy bleeding (both 0.05). Multiple polyps (=17.49, 95% 9.82-31.18), right-colon involvement (=3.44, 95% 1.89-6.26) and non-hamartoma (=2.51, 95% 1.04-6.07) were risk factors for polyp recurrence (all 0.05). Colonoscopic high-frequency electrocoagulation snare polypectomy has low incidence of post-polypectomy bleeding and polyp recurrence. Female patients and sessile polyps have higher risk for post-polypectomy bleeding. Multiple polyps, right-colon involvement and non-hamartoma polyps increase the risk for polyp recurrence.
探讨结肠镜下高频电凝圈套息肉切除术后息肉切除术后出血及息肉复发的发生率和危险因素。回顾性分析2009年1月至2020年12月在浙江大学医学院附属儿童医院接受结肠镜下高频电凝圈套息肉切除术的1826例儿童的临床资料。收集人口学特征、内镜表现、病理特征、诊断、息肉切除术后出血及息肉复发情况。采用Logistic回归分析相关危险因素。共纳入1826例儿童(男1191例,女635例),共进行1967次息肉切除术。初次诊断时年龄为4.6(3.2,6.4)岁。根据初次结肠镜检查,1611例儿童(88.2%)有单发息肉,1707例儿童(93.5%)有带蒂息肉,1151例儿童(63.0%)息肉累及直肠,1757例儿童(96.2%)有错构瘤性息肉。73例儿童(4.0%)诊断为息肉病综合征。息肉切除术后出血发生率为3.8%(75/1967)。88例儿童(4.8%)息肉复发。女孩(=2.01,95% 1.26 - 3.23)和无蒂息肉(=2.28,95% 1.15 - 4.49)是息肉切除术后出血的危险因素(均0.05)。多发息肉(=17.49,95% 9.82 - 31.18)、右半结肠受累(=3.44,95% 1.89 - 6.26)和非错构瘤(=2.51,95% 1.04 - 6.07)是息肉复发的危险因素(均0.05)。结肠镜下高频电凝圈套息肉切除术息肉切除术后出血和息肉复发发生率低。女性患者和无蒂息肉息肉切除术后出血风险较高。多发息肉、右半结肠受累和非错构瘤性息肉增加息肉复发风险。