Objective: To explore the incidence and the risk factors of post-polypectomy bleeding and polyp recurrence after colonoscopic high-frequency electrocoagulation snare polypectomy. Methods: Clinical data of 1 826 children who underwent colonoscopic high-frequency electrocoagulation snare polypectomy in the Children's Hospital, Zhejiang University School of Medicine from January 2009 to December 2020 was retrospectively analyzed. Demographic characteristics, endoscopic manifestations, pathological features, diagnosis, occurrence of post-polypectomy bleeding and polyp recurrence were collected. The associated risk factors were analyzed by Logistic regression. Results: A total of 1 826 children (1 191 males and 635 females) with 1 967 polypectomies were included. The age was 4.6 (3.2, 6.4) years at initial diagnosis. According to the initial colonoscopy, 1 611 children (88.2%) had solitary polyps, 1 707 children (93.5%) had pedicled polyps, 1 151 children (63.0%) had polyps involving the rectum, and 1 757 children (96.2%) had hamartomatous polyps. Polyposis syndromes were diagnosed in 73 children (4.0%). The post-polypectomy bleeding occurrence was 3.8% (75/1 967). Polyps recurred in 88 children (4.8%). Girls (OR=2.01, 95%CI 1.26-3.23) and sessile polyps (OR=2.28, 95%CI 1.15-4.49) were risk factors for post-polypectomy bleeding (both P<0.05). Multiple polyps (OR=17.49, 95%CI 9.82-31.18), right-colon involvement (OR=3.44, 95%CI 1.89-6.26) and non-hamartoma (OR=2.51, 95%CI 1.04-6.07) were risk factors for polyp recurrence (all P<0.05). Conclusions: Colonoscopic high-frequency electrocoagulation snare polypectomy has low incidence of post-polypectomy bleeding and polyp recurrence. Female patients and sessile polyps have higher risk for post-polypectomy bleeding. Multiple polyps, right-colon involvement and non-hamartoma polyps increase the risk for polyp recurrence.
目的： 探讨儿童大肠息肉结肠镜下高频电凝圈套切除治疗术后出血、息肉复发的发生情况及危险因素。 方法： 回顾性分析2009年1月至2020年12月浙江大学医学院附属儿童医院电子结肠镜下高频电凝圈套切除治疗大肠息肉1 826例患儿的临床资料。收集患儿人口学信息、内镜下息肉表现、病理类型、临床诊断、术后出血及息肉复发等资料，Logistic回归分析息肉切除术后出血及息肉复发的危险因素。 结果： 1 826例患儿接受1 967例次结肠镜下高频电凝圈套切除术，男1 191例（65.2%），女635例（34.8%），初次确诊大肠息肉的年龄为4.6（3.2，6.4）岁。首次结肠镜下发现单发息肉1 611例（88.2%），有蒂息肉1 707例（93.5%），直肠累及1 151例（63.0%），病理类型为错构瘤性1 757例（96.2%）。诊断息肉综合征73例（4.0%）。息肉切除术后出血发生率为3.8%（75/1 967）。息肉复发88例（4.8%）。多因素Logistic回归分析，女童（OR=2.01，95%CI 1.26~3.23）及无蒂息肉（OR=2.28，95%CI 1.15~4.49）均为息肉切除术后出血的危险因素（均P<0.05）。多发息肉（OR=17.49，95%CI 9.82~31.18）、右侧结肠累及（OR=3.44，95%CI 1.89~6.26）以及非错构瘤性息肉（OR=2.51，95%CI 1.04~6.07）均为息肉复发的危险因素（均P<0.05）。 结论： 儿童大肠息肉高频电凝圈套切除术后出血发生率低，息肉复发率低。女童、无蒂息肉切除术后出血风险增高，而多发、右侧结肠累及和非错构瘤性息肉术后息肉复发风险增高。.