Journal of Clinical Pediatrics >
Endoscopic characteristics and treatment of colorectal polyps in children
Received date: 2024-02-20
Online published: 2024-07-08
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.
Yangyi PENG , Xiao WANG , Cheng FAN , Qinju LIU , Xiaosong ZHAO , Li ZHU . Endoscopic characteristics and treatment of colorectal polyps in children[J]. Journal of Clinical Pediatrics, 2024 , 42(7) : 637 -642 . DOI: 10.12372/jcp.2024.24e0136
[1] | Thakkar K, Fishman DS, Gilger MA. Colorectal polyps in childhood[J]. Curr Opin Pediatr, 2012, 24(5): 632-637. |
[2] | 马昕, 钟雪梅. 儿童结直肠息肉的临床特征[J]. 中国实用儿科杂志, 2022, 37(12): 886-889. |
[3] | 黄瑛, 耿岚岚, 楼金玕, 等. 麻醉状态下儿童择期结肠镜检查肠准备专家共识[J]. 中国循证儿科杂志, 2021, 16(2): 81-87. |
[4] | Fukutomi H. Endoscopic diagnosis of protruding lesions of the stomach[J]. Iryo, 1967, 21(8): 940-946. |
[5] | Kawada PS, O'Loughlin EV, Stormon MO, et al. Are we overdoing pediatric lower gastrointestinal endoscopy?[J]. J Pediatr Gastroenterol Nutr, 2017, 64(6): 898-902. |
[6] | 申红日. 小儿下消化道出血460例临床分析[J]. 中国药物与临床, 2017, 17(9): 1355-1356. |
[7] | 庞良宗, 唐清, 云翔, 等. 儿童结肠息肉的临床特点和病理分析[J]. 广西医科大学学报, 2021, 38(8): 1590-1594. |
[8] | 刘波, 张慧华, 张慧晖, 等. 儿童结直肠息肉1351例的临床特征及内镜下治疗效果分析[J]. 中国当代儿科杂志, 2022, 24(4): 354-359. |
[9] | 江米足. 儿童消化内镜的发展与思考[J]. 中国当代儿科杂志, 2022, 24(4): 350-353. |
[10] | Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection(EMR): European Society of Gastrointestinal Endoscopy(ESGE) Clinical Guideline[J]. Endoscopy, 2017, 49(3): 270-297. |
[11] | Dornblaser D, Young S, Shaukat A. Colon polyps: updates in classification and management[J]. Curr Opin Gastroenterol, 2024, 40(1): 14-20. |
[12] | 李小芹, 王跃生. 儿童结直肠息肉的内镜治疗[J]. 中国实用儿科杂志, 2018, 33(11): 831-836. |
[13] | Kamal F, Khan MA, Lee-Smith W, et al. Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps: meta-analysis of randomized controlled trials[J] .Gastrointest Endosc, 2023, 98(1): 7-18. |
[14] | 葛库库, 方莹. 儿童结直肠息肉内镜下切除方法选择原则[J]. 中国实用儿科杂志, 2022, 37 (12): 893-898. |
[15] | Lee Y, Choi S, Kang B. Practice patterns of colorectal polypectomy in pediatric endoscopic specialists in south korea: a nationwide survey study[J]. Pediatr Gastroenterol Hepatol Nutr, 2023, 26(1): 15-22. |
[16] | 戚伶俐, 庞晓丽, 焦许果, 等. 儿童结直肠息肉病理特征及术后随访[J]. 中国实用儿科杂志, 2022, 37(12): 906-911. |
[17] | Latchford A, Cohen S, Auth M, et al. Management of Peutz-Jeghers syndrome in children and adolescents: a position paper from the ESPGHAN Polyposis Working Group[J]. J Pediatr Gastroenterol Nutr, 2019, 68(3): 442-452. |
[18] | Kaltenbach T, Anderson JC, Burke CA, et al. Endoscopic removal of colorectal lesions: recommendations by the US Multi-Society Task Force on Colorectal Cancer[J]. Am J Gastroenterol, 2020, 115(3): 435-464. |
[19] | 李娜, 陶玉荣, 谢惠, 等. 幼年性息肉及幼年性息肉综合征患儿临床及内镜特征分析[J]. 胃肠病学和肝病学杂志, 2020, 29(10): 1142-1144. |
[20] | Fox VL, Perros S, Jiang H, et al. Juvenile polyps:recurrence in patients with multiple and solitary polyps[J]. Clin Gastroenterol Hepatol, 2010, 8(9): 795-799. |
[21] | Cohen S, Hyer W, Mas E, et al. Management of juvenile polyposis syndrome in children and adolescents: a position paper from the ESPGHAN Polyposis Working Group[J]. J Pediatr Gastroenterol Nutr, 2019, 68(3): 453-462. |
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