关键词: 大肠息肉, 结肠镜, 幼年性息肉病综合征, 便血, 内镜下黏膜切除术

Abstract:

Objective To explore the clinical, endoscopic, and histopathological characteristics of colorectal polyps in children, as well as the application of different endoscopic treatment methods, so as to provide reference value for the clinical diagnosis and treatment of colorectal polyps in children. Methods The clinical data of 361 children under 14 years of age diagnosed with colorectal polyps and undergoing painless colonoscopy examination and treatment were retrospectively analyzed. Results Colorectal polyps in children are more commonly seen in males (245 cases, 67.87 %) compared to females (116 cases, 32.13 %). The most prevalent age group is the preschool period, accounting for 44.88 % (162/361) of all patients. The most common symptom is hematochezia, observed in 86.70 % (313/361) of cases. There were 288 cases (79.78 %) with a single polyp and 73 cases (20.22 %) with multiple polyps. The polyps in children are mainly located in the left half of the colon (347 cases, 96.12 %). The clinical manifestations and the number of polyps differ significantly across different age groups of children (P<0.05). Endoscopic polypectomy was performed on 459 polyps, all of which were successfully removed. Intraoperative bleeding occurred in 252 cases (69.81 %), and metallic titanium clip closure was the most commonly used hemostasis method (186 cases, 73.81 %). There were 12 patients with recurrence (3.32 %), and the patients with multiple polyps were more likely to relapse (P<0.001). Conclusions Colorectal polyps are more commonly found in male children, with hematochezia being the most frequent clinical symptom. They are prevalent during the preschool age, often located in the left half of the colon, and usually appear as single formations. The predominant morphology is Yamada type IV, with large polyps being the most common. Histopathologically, juvenile polyps are the primary type. Polyps of different shapes and sizes were treated by different endoscopic methods. Micro polyps without a stalk are mainly treated using cold forceps polypectomy; giant polyps and those with a stalk are primarily removed using hot snare polypectomy; small polyps and those without a stalk are mainly treated using endoscopic mucosal resection.

Key words: colorectal polyp, colonoscopy, juvenile polyposis syndrome, hematochezia, endoscopic mucosal resection