ObjectiveTo investigate: 1) the demographics and clinical characteristics, 2) the findings, and 3) the safety and effectiveness in a cohort of Chinese pediatric patients undergoing colonoscopy.MethodsThe study participants were consecutive patients aged ≤14 years old that underwent their first colonoscopy in the endoscopy center at the First Affiliated Hospital, Sun Yat-sen University between Jan. 1, 2001 and Dec. 31, 2012. Demographic, clinical, endoscopic, and pathological findings were collected.ResultsThe cohort consisted of 322 patients, including 218 boys (67.7%) and 104 girls (32.3%). The median age was 8.0 years old and ranged from 9 months to 14 years old. Hematochezia (48.8%) and abdominal pain/discomfort (41.3%) were the most common presentations preceding pediatric colonoscopy. The caecal intubation success rate was 96.3%. No serious complications occurred during the procedures. A total of 227 patients (70.5%) received a positive diagnosis under endoscopy, including 138 patients with polyps and 53 patients with inflammatory bowel disease (IBD). Among the patients with polyps, 71.0% were juvenile polyps. Comparisons between years 2001–2006 and 2007–2012 showed that the IBD detection rate increased significantly (4.6% vs. 22.4%, P<0.001), while the opposite occurred for the polyp detection rate (73.1% vs. 27.6%, P<0.001).ConclusionColonoscopy in pediatric patients is a safe and effective procedure. Polyps are the primary finding during colonoscopy. In South China there has been an increase in pediatric patients diagnosed with IBD over the past decade. However, a large epidemiological study is needed to confirm our findings.
Adenomas and serrated polyps were increasingly detected throughout the colon, whereas advanced adenomas were only in proximal colon. A proximal shift tendency detected by colonoscopy was observed for adenomas, but not advanced adenomas or serrated polyps, in Southern China. The screening for proximal polyps should be emphasized and colonoscopy might be a preferred initial screening tool.
Background To date, it is not clarified whether patients with gastric polyps without any alarming symptoms for colorectal neoplasia need colonoscopy screening. The objective of this study is to prospectively determine the association between gastric polyps and colorectal neoplasia. Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments. Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the ageand sex-matched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.34, 95% confidence interval [CI]: 1.79 to 3.06, p<0.001) and advanced colorectal adenomas (adjusted OR=2.71, 95% CI: 1.74 to 4.23, p<0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p<0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p<0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p<0.001). Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.
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