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[Endoscopic treatment of colorectal polyps in children]
P Spinelli1, P Pizzetti, A Pauletti
1Divisione di Endoscopia, Istituto nazionale per lo studio e la cura dei tumori, Milano, Italia.
Insights
Pediatric colorectal polyps are often non-neoplastic, primarily juvenile polyps. Endoscopic polypectomy in children is safe and technically similar to adults, with low complication rates.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
- Colorectal Surgery
Context:
- Colorectal polyps are less common in children than adults.
- Over 70% of infant colorectal polyps are non-neoplastic (juvenile or hamartomatous).
- Pediatric endoscopic procedures require different preparation and often general anesthesia.
Purpose:
- To review the characteristics and management of colorectal polyps in pediatric patients.
- To assess the safety and technical aspects of endoscopic polypectomy in children.
- To evaluate the follow-up strategies for non-neoplastic pediatric polyps.
Summary:
- A retrospective review of 33 colorectal polyps removed from 20 pediatric patients (ages 2-14) between 1974-1987.
- Histological analysis revealed 18 juvenile polyps, 6 hyperplastic polyps, and 1 tubular adenoma.
- Endoscopic polypectomy was technically similar to adults, with only one post-polypectomy bleed complication observed.
Impact:
- Highlights the safety and efficacy of endoscopic polypectomy in pediatric patients.
- Emphasizes the distinct nature of juvenile polyps and their impact on follow-up protocols.
- Provides valuable data on pediatric colorectal polyp management and outcomes.
Abstract:
In paediatric patients colorectal polyps are less frequent than in adults. In infancy, more than 70% of colorectal polyps are non-neoplastic (juvenile or amartomatous). Intestinal and pharmacological preparation are different in children with respect to adults. In infants and young children, endoscopic polypectomy is performed under general anaesthesia. From the technical viewpoint, there are no substantial differences between adult and paediatric patients. Moreover, the fact that juvenile polyps are not neoplastic in nature, generally influences the modalities of follow up. In the Division of Endoscopy of the I.N.T., from 1974 to 1987, 33 colorectal polyps were removed in 20 patients (13 M, 7 F). The age range was 2 to 14 years. Only one complication was observed: a post-polypectomy bleed, which was treated endoscopically. Histologically, there were 18 juvenile polyps, 6 hyperplastic polyps, 1 tubular adenoma; 8 polyps (6 in the same patient) were not retrieved.