Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy. Methods: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated. Results: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions: In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.
Abstract
Background/Aims: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy. Methods: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated. Results: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions: In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.
참고문헌 (18)
- Kay M, "Colonic polyps and polyposis syndromes in pediatric patients", Curr Opin Pediatr, 27, pp.634~641 (2015)
- Ari Silbermintz, "Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding", Clinical Endoscopy, 52(3), pp.258~261 (2019), 대한소화기내시경학회[DOI]
- Thakkar K, "Colorectal polyps in childhood", Curr Opin Pediatr, 24, pp.632~637 (2012)
- Latchford A, "Management of Peutz-Jeghers syndrome in children and adolescents : a position paper from the ESPGHAN Polyposis Working Group", J Pediatr Gastroenterol Nutr, 68, pp.442~452 (2019)
- Thakkar K, "Prevalence of colorectal polyps in pediatric colonoscopy", Dig Dis Sci, 57, pp.1050~1055 (2012)
- Cohen S, "Management of juvenile polyposis syndrome in children and adolescents : a position paper from the ESPGHAN Polyposis Working Group", J Pediatr Gastroenterol Nutr, 68, pp.453~462 (2019)
- Wirtzfeld DA, "Hamartomatous polyposis syndromes : molecular genetics, neoplastic risk, and surveillance recommendations", Ann Surg Oncol, 8, pp.319~327 (2001)
- Ibrahimi N, "Polyp characteristics of nonsyndromic and potentially syndromic juvenile polyps : a retrospective cohort analysis", J Pediatr Gastroenterol Nutr, 69, pp.668~672 (2019)
- Dipasquale V, "The management of colonic polyps in children : a 13-year retrospective study", Eur J Pediatr, 180, pp.2281~2286 (2021)
- 이연주, "The Most Common Cause of Lower Gastrointestinal Bleeding without Other Symptoms in Children is Colonic Polyp: Is Total Colonoscopy Needed?", Clinical Endoscopy, 52(3), pp.207~208 (2019), 대한소화기내시경학회[DOI]
- Hoffenberg EJ, "Symptomatic colonic polyps in childhood : not so benign", J Pediatr Gastroenterol Nutr, 28, pp.175~181 (1999)
- Rathi C, "Clinical, endoscopic, and pathologic characteristics of colorectal polyps in Indian children and adolescents", Indian J Gastroenterol, 34, pp.453~457 (2015)
- Lehmann CU, "Juvenile polyps and their distribution in pediatric patients with gastrointestinal bleeding", W V Med J, 92, pp.133~135 (1996)
- Yuanzhen Hao, "Risk Factors for Recurrent Colorectal Polyps", Gut and Liver, 14(4), pp.399~411 (2020), 거트앤리버 소화기연관학회협의회[DOI]
- Vipin Gupta, "Optimal Endoscopic Treatment and Surveillance of Serrated Polyps", Gut and Liver, 14(4), pp.423~429 (2020), 거트앤리버 소화기연관학회협의회[DOI]
- Qumseya BJ, "The effect of polyp location and patient gender on the presence of dysplasia in colonic polyps", Clin Transl Gastroenterol, 3, pp.e20~ (2012)
- Di Nardo G, "Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding : a prospective study", Ital J Pediatr, 46, pp.66~ (2020)
- Subarna Rani Das, "Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker", Pediatric Gastroenterology, Hepatology & Nutrition, 25(1), pp.52~60 (2022), 대한소아소화기영양학회[DOI]