Wang F F, Fang Y, Ren X X, Yang H B, Ge K K, Zhang H H, Wang H, Sun L N
Department of Gastroenterology, Xi' an Children' s Hospital, Xi'an 710003, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2022 Sep 6;56(9):1327-1332. doi: 10.3760/cma.j.cn112150-20220117-00061.
To analyze the clinical and endoscopic characteristics of colorectal polyps in children, and to explore the detection rate, age and gender distribution characteristics, endoscopic treatment effect and follow-up monitoring of colorectal polyps in children, so as to provide reference for disease management of colorectal polyps in children. The clinical and endoscopic characteristics of children with colorectal polyps in Xi 'an Children's Hospital from January 2019 to December 2019 were retrospectively analyzed. The patients were divided into 5 groups according to age (y): 0<y<1 years, 1≤ y<4 years, 4≤ y<7 years, 7≤ y<12 years, and 12≤ y ≤18 years. Independent sample test, Pearson Chi-square test (χ) were used to compare groups' differences. The results showed that a total of 724 colonoscopies were completed in 2019, and 160 colorectal polyps were diagnosed, with a detection rate of 22.10%. Among the children with colorectal polyps, 105 were males, accounting for 65.62%, and 55 were females, accounting for 34.38%. The detection rate of male colorectal polyps was 22.68%, and the detection rate of female colorectal polyps was 21.08%. There was no significant difference in the detection rate of colorectal polyps between males and females (χ = 0.25, =0.617). Children with colorectal polyps were most common in the age group of 1≤ y<4 years, 72 cases, accounting for 41.14%(72/175). The detection rate of colorectal polyps in different age groups was statistically significant (χ=73.929, <0.05). The main symptom of children with colorectal polyps was hematochezia, accounting for 87.5% (140/160). Colorectal polyps were mainly single polyps in 140 patients, accounting for 87.50%, 15 patients had 2-4 polyps, accounting for 9.38%, and 5 patients had 5 or more polyps, accounting for 3.12%. A total of 210 polyps were removed, and the most common site of polyps was rectum, 123 polyps, accounting for 58.57% (123/210). 111 (52.86%, 111/210) of them were 1 cm to 2 cm in diameter. The Yamada classification was mainly type Ⅲ, 114 pieces, accounting for 54.29% (114/210). Among the 210 polyps with diameter ≥0.5 cm, 165 were removed by endoscopic mucosal resection, accounting for 78.57% (165/210). There were 23 patients with postoperative complications, including hematochezia, abdominal pain, fever, vomiting, diarrhea, dizziness, and no gastrointestinal perforation. Juvenile polyps were the main pathological type, accounting for 88.13% (141/160). The children with juvenile polyps were followed up for 3-30 months, and recurrence was considered in 2 of them. In conclusion, the detection rate of colorectal polyps in children aged 1≤ y<4 years is high, and hematochezia is the main clinical manifestation. Standardized endoscopic treatment and follow-up monitoring are very important for children with colorectal polyps.
分析儿童大肠息肉的临床及内镜特征，探讨儿童大肠息肉的检出率、年龄及性别分布特点、内镜治疗效果及随访监测情况，为儿童大肠息肉的疾病管理提供参考。回顾性分析2019年1月至2019年12月西安儿童医院大肠息肉患儿的临床及内镜特征。根据年龄（岁）将患儿分为5组：0＜y＜1岁、1≤y＜4岁、4≤y＜7岁、7≤y＜12岁、12≤y≤18岁。采用独立样本t检验、Pearson卡方检验（χ²）比较组间差异。结果显示，2019年共完成结肠镜检查724例，诊断大肠息肉160例，检出率为22.10%。大肠息肉患儿中，男性105例，占65.62%，女性55例，占34.38%。男性大肠息肉检出率为22.68%，女性大肠息肉检出率为21.08%。男女大肠息肉检出率差异无统计学意义（χ² = 0.25，P =0.617）。大肠息肉患儿以1≤y＜4岁年龄组最为常见，72例，占41.14%（72/175）。不同年龄组大肠息肉检出率差异有统计学意义（χ²=73.929，P＜0.05）。大肠息肉患儿主要症状为便血，占87.5%（140/160）。大肠息肉以单发息肉为主，140例，占87.50%，15例有2～4枚息肉，占9.38%，5例有5枚及以上息肉，占3.12%。共切除息肉210枚，息肉最常见部位为直肠，123枚，占58.57%（123/210）。其中111枚（52.86%，111/210）直径为1 cm至2 cm。山田分型以Ⅲ型为主，114枚，占54.29%（114/210）。直径≥0.5 cm的210枚息肉中，165枚经内镜黏膜切除术切除，占78.57%（165/210）。术后有23例患儿出现并发症，包括便血、腹痛、发热、呕吐、腹泻、头晕，无胃肠道穿孔。幼年性息肉为主要病理类型，占88.13%（141/160）。对幼年性息肉患儿随访3～30个月，其中2例考虑复发。综上所述，1≤y＜4岁儿童大肠息肉检出率高，便血为主要临床表现。规范的内镜治疗及随访监测对大肠息肉患儿非常重要。
