Study on related factors of postoperative complications after endoscopic treatment for colon polyps in children / 中国实用儿科杂志

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics and related factors of postoperative complications in children with colon polyps treated by endoscopy. METHODS: Clinical data of 379 hospitalized children who underwent electronic colonoscopic polypectomy in Children's Hospital Affiliated to Xi'an Jiaotong University from January 2014 to December 2016 were collected and retrospectively analyzed. RESULTS: Among 379 patients with polypectomy,36 patients(9.1%)had related complications,including fever in 6 patients(1.6%)and bleeding in 30 patients(7.9%);there was no intestinal perforation.Among the 30 cases of bleeding,26 cases(6.9%)were with minor bleeding,and 4 cases(1.1%)were with massive bleeding.The bleeding was successfully stopped by emergency endoscopy,and no additional surgery was performed. Univariate correlation analysis found that the duration of hematochezia,the location of the polyp,being with pedicle or not,the method of resection and postoperative braking were significantly correlated with postoperative complications(P<0.05). Multi-factor Logistic regression analysis found thatthe longer the time of hematochezia,the higher the risk of postoperative complications,OR value being 1.08[95%CI(1.03,2.14),P=0.003]. Patients with non-rectal polyps(including transverse colon,ascending colon and ileocecal)were 18.88 times more likely to have postoperative complications than patients with rectal polyps[95%CI(2.23,159.74),P=0.007]. The risk of postoperative complications in patients with pedicle was 11.424 times higher than that in patients without pedicle[95%CI(2.42,53.91),P=0.002]. CONCLUSION: Endoscopic resection of colon polyps in children is safe and effective,and postoperative bleeding is the most common complication. The longer period of hematochezia,the polyp being farther away from the anus,and being with pedicle increases the risk of postoperative complications. The use of titanium clips,strict postoperative braking and softening stool can reduce the occurrence of complications.