Division of Gastroenterology, Hepatology and Nutrition, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; The University of Missouri in Kansas City School of Medicine, Kansas City, MO, USA.
Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gastrointest Endosc Clin N Am. 2023 Apr;33(2):463-486. doi: 10.1016/j.giec.2022.11.001.
Polypectomy is the most common therapeutic endoscopic intervention in children. Management of sporadic juvenile polyps is limited to polypectomy to resolve symptoms, whereas polyposis syndromes pose a multidisciplinary challenge with broader ramifications. In preparation for polypectomy, there are key patient, polyp, endoscopy unit, and provider characteristics that factor into the likelihood of success. Younger age and multiple medical comorbidities increase the risk of adverse outcomes, classified as intraoperative, immediate postoperative, and delayed postoperative complications. Novel techniques, including cold snare polypectomy, can significantly decrease adverse events but a more structured training process for polypectomy in pediatric gastroenterology is needed.
息肉切除术是儿童最常见的治疗性内镜介入治疗方法。散发性幼年性息肉的处理仅限于息肉切除术以缓解症状,而息肉病综合征则是一个多学科的挑战,具有更广泛的影响。在准备进行息肉切除术时,有一些关键的患者、息肉、内镜科室和提供者特征会影响手术的成功率。年龄较小和多种合并症会增加不良结局的风险,包括术中、术后即刻和术后延迟并发症。包括冷圈套息肉切除术在内的新技术可以显著降低不良事件的发生,但在儿科胃肠病学中需要一个更具结构性的息肉切除术培训过程。