Short- and long-term results of colonoscopic polypectomy in children

Bartnik, W; Butruk, E; Ryzko, J; Rondio, H; Rasiński, A; Orłowska, Janina

doi:10.1016/s0016-5107(86)71917-2

Cited by 22 publications

(21 citation statements)

References 13 publications

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“…Although the majority of polyps in children appeared in a distal location, the frequency of the proximal location varied from 5%-32% (1,3,9,14,17,24,27,32) . In the present study, polyps located proximal do the splenic flexure was found in 35% of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…Gastrointestinal polyps are common in the pediatric age group, with lesions presenting juvenile harmatomatous histology identified in 88%-100% of the polyps removed by colonscopy (3,9,24,30) . The polyposis syndromes are quite rare, varying between 12% and 17% (14,19,21) , while the JPS is predominant in the majority of pediatric cases (9,19,21,30) .…”

Section: Discussionmentioning

confidence: 99%

“…Denise O ANDRADE 1 , Alexandre Rodrigues FERREIRA 1 , Paulo Fernando S BITTENCOURT 1 , Daniela F P RIBEIRO 1 , Rodrigo Gomes da SILVA Reports in prior literature describe the occurrence of multiple polyps in 20%-50% of the children submitted to a colonoscopy with polypectomy (3,9,14,15,(22)(23)(24)26) , in which 10%-50% of the polyps can be found near the sigmoid colon (17,23,27,31) , while 3%-15% can be found exclusively in the right colon (including the transverse colon, the ascending colon, and the cecum) (3,9,17) . Children with multiple juvenile polyps, especially those with Juvenile Polyposis syndrome (JPS), can develop adenomatous transformations or even carcinomas in situ in the juvenile polyp in 26%-47% of the patients (5,15,23) .…”

Section: Clinical Epidemiologic and Endoscopic Profile In Children mentioning

confidence: 99%

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Clinical, Epidemiologic, and Endoscopic Profile in Children and Adolescents With Colonic Polyps in Two Reference Centers

Andrade

Ferreira

Bittencourt

et al. 2015

Arq. Gastroenterol.

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-Background -The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Methods -Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of intestinal polyposis and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, histology, and distribution. Polyposis syndromes were also investigated. Results -From the 233 patients submitted to colonoscopies, polyps were found in 74 (31.7%) patients, with a median age of 6.6 years, of which 61% were male. Juvenile polyps were identified in 55 (74%) patients, with 7 (9%) characterized within the criteria for juvenile polyposis. Patients with intestinal polyposis syndromes were diagnosed in 35% of the patients. The most frequent clinical presentation was hematochezia. Abdominal pain with acute episodes of intestinal partial obstruction or intussusception with emergency laparotomy was observed in the majority of Peutz-Jeghers syndrome patients leading to an increased morbidity. Conclusions -Even though juvenile colonic polyps are the most frequent type of diagnosed polyps, the present study identified a significant level of children with polyposis syndromes (35%), associated with a higher morbidity of these individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Epidemiologic and Endoscopic Profile In Children mentioning

confidence: 99%

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Clinical, Epidemiologic, and Endoscopic Profile in Children and Adolescents With Colonic Polyps in Two Reference Centers

Andrade

Ferreira

Bittencourt

et al. 2015

Arq. Gastroenterol.

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“…In pediatric studies, rates of bleeding-related complications during polypectomy ranged from 0%-5.6%. [13][14][15][16] Juvenile polyps, the most frequent type of polyp identified in children, have peak prevalence in children ages 1-7 years. 17,18 However, the adjusted analysis showed that polypectomy is an independent predictor of bleeding-related complications.…”

Section: Discussionmentioning

confidence: 99%

Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Thakkar

El–Serag

Mattek

et al. 2008

Clinical Gastroenterology and Hepatology

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Colonoscopy has become a routine modality for the evaluation and treatment of colonic disorders in children. Although generally considered a safe procedure, colonoscopy has the potential for complications. Most informed consent forms describe adverse effects of sedative medicines, perforation, infection, and bleeding as possible risks of colonoscopy. However, the frequency of these complications remains unclear. There are limited pediatric data showing complication rates, and most prior studies involved small numbers of procedures. Furthermore, there might be additional complications that need to be added to consent protocols, because most current complication data are extrapolated from the much larger experience in adult populations.A review of pediatric literature demonstrated a wide array of potential complications and no large multicenter studies during the past 25 years. The largest study was conducted in [1978][1979] and included a survey of 1400 proctosigmoidoscopies performed during an 18-month period at 25 medical centers in the U.S. 1 This study was only published in abstract form and reported complications in 0.2% of all colonoscopy procedures. These complications included one hemorrhage requiring transfusion and one perforation. In the second largest study, Stringer et al 2 prospectively described a series of 250 flexible colonoscopies done in the United Kingdom during a 3.5-year period with no adverse events. Several other studies reported complications (Table 1) in pediatric colonoscopy, but the majority of these studies examined a small number of procedures.Determination of potential colonoscopy-related complications and their expected frequency in children can lead to enhanced risk-benefit analysis by physicians and patients and improved informed consent. There is a lack of systematic, multicenter studies in the pediatric population. Therefore, we conducted the current study to examine the frequency, type, and clinical determinants of immediate complications encountered during pediatric Address requests for reprints to: Kalpesh Thakkar, MD, 6621 Fannin St CCC 1010, Houston, TX 77030. kthakkar@bcm.tmc.edu; fax: 832-825-3633. Simple logistic regression was used to estimate the crude risk of cardiopulmonary events and gastrointestinal bleeding for variables that were identified as significantly associated with the outcomes during categorical analysis (P < .05). Multiple logistic regression models included all variables determined significant on univariate analysis. In constructing the models, we followed the commonly used heuristic of 10 outcome events for each explanatory variable. The adjusted risks estimate for each independent predictor variable was expressed as odds ratios. All analyses were performed by using SAS software (SAS Institute, Inc, Cary, NC). HHS Public Access ResultsDuring the study period, 8841 colonoscopies were recorded at 12 PEDS-CORI sites, and 1049 (11.9%) were excluded for incomplete procedure notes, duplicate records, or patient age older than 18 years. Thus, a total of 77...

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“…11, 1991; accepted on Feb. 25,1994) reported that fatal malignancies of the gastrointestinal tract in children under 14 years old accounted for only 3.3% of all fatal malignancies in this age group compared with 39.3% in adults. Colon malignancy is estimated to account for 0.4% of all fatal malignancies in patients under 15 years of age.…”

Section: -4 Pickett and Briggsmentioning

confidence: 99%

Carcinoma of the colon in children: Case report and review of the Japanese literature

et al. 1994

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A 15-year-old female presenting with anemia and positive for occult blood was diagnosed as having an adenomatous polyp with mild atypia in the cecum by colonoscopy. Microscopically, the majority of the surface of the tubulovillous adenoma was occupied by a well-differentiated adenocarcinoma, indicating that the adenoma-carcinoma sequence is involved in the development of colon cancers, even in children. Forty-three cases of proven carcinoma of the colon in Japanese children aged under 15 years are also reviewed. The majority of the patients were aged over 10. Although an emergency laparotomy was undertaken in 42.5% of these patients, the signs and symptoms observed in these children did not markedly differ from those of adults. Colon cancer should not be excluded in children only on the basis of age, and barium enema and colonoscopy should therefore be applied to pediatric patients with unexplainable bleeding and abdominal pain, especially those over 10 years of age.

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Short- and long-term results of colonoscopic polypectomy in children

Cited by 22 publications

References 13 publications

Clinical, Epidemiologic, and Endoscopic Profile in Children and Adolescents With Colonic Polyps in Two Reference Centers

Clinical, Epidemiologic, and Endoscopic Profile in Children and Adolescents With Colonic Polyps in Two Reference Centers

Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Carcinoma of the colon in children: Case report and review of the Japanese literature

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