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[Clinical characteristics and risk factors of post polypectomy electrocoagulation syndrome in children]
1Department of Gastroenterology, Children's Hospital Affiliated to Zhengzhou University, Children's Hospital of Henan Province, Zhengzhou 450000, China.
Insights
Post polypectomy electrocoagulation syndrome (PPECS) in children presents with fever and abdominal pain. Key risk factors for PPECS include large polyps (≥25 mm), broad-based polyps, and right-sided colon locations.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Surgery
Background:
- Post polypectomy electrocoagulation syndrome (PPECS) is a potential complication following endoscopic polypectomy.
- Understanding the clinical characteristics and risk factors of PPECS in children is crucial for prevention and management.
Purpose of the Study:
- To investigate the clinical features of PPECS in pediatric patients.
- To identify independent risk factors associated with the development of PPECS in children undergoing endoscopic polypectomy.
Main Methods:
- Retrospective analysis of clinical data from 23 children diagnosed with PPECS and 115 controls who underwent polypectomy.
- Logistic regression analysis was employed to determine independent risk factors for PPECS.
Main Results:
- The incidence of PPECS was 1.1% (23/2083 children).
- Common symptoms included abdominal pain and fever, with a higher prevalence in children younger than 3 years.
- Independent risk factors identified were lesion size ≥25 mm, broad-based polyps, and lesions located in the right hemicolon.
Conclusions:
- Pediatric PPECS is characterized by fever, abdominal pain, and leukocytosis post-procedure.
- Lesion size ≥25 mm, broad-based morphology, and right hemicolon location are significant independent risk factors for pediatric PPECS.
Abstract:
Objective: To study the clinical characteristics and risk factors of post polypectomy electrocoagulation syndrome (PPECS) in children. Methods: Clinical data of 23 children with PPECS in Children's Hospital Affiliated to Zhengzhou University from January 2015 to December 2019 were retrospectively analyzed. Additionally, 115 children without PPECS who had polypectomy performed by the same endoscopist at the same time were collected into the control group. The morbidity, clinical characteristics and therapeutic protocol were analyzed, and the risk factors of PPECS were analyzed by Logistic regression. Results: Among the total 2 083 children who had endoscopic polypectomy with electrocautery, 23 children (1.1%) developed PPECS. All had abdominal pain and fever. The average age of the children with PPECS was (3.5±1.5) years, including 19 cases (82.6%) younger than 3 years. There were 18 cases with polyps larger than 25 mm (78.3%). The endoscopic operation time ((56±15) vs. (24±8) min, t=18.086, P<0.01), the rate of piecemeal resection (78.3% (18/23) vs. 17.4% (20/115), χ2=17.358, P<0.01), the lesion size ((38.4±3.7) vs. (15.8±4.3) mm, t=15.127, P<0.01), the proportion of polyps located in the right hemicolon (47.8% (11/23) vs. 23.5% (27/115), χ2=7.035, P<0.05), and the proportion of broad-based polyps (78.3% (18/23) vs. 25.2% (29/115), χ2 = 29.259, P<0.01) in the PPECS group were all significantly higher than those in the non-PPECS group. Similarly, the leukocyte counts ((17.4±4.5)×109/L vs. (8.5±1.2)×109/L, t=6.085, P<0.05) and C-reactive protein ((25.8±3.6) vs. (1.1±0.6) mg/L, t=5.531, P<0.05) in the PPECS group were higher than those in the non-PPECS group. The results of multivariate Logistic regression analysis indicated that lesion size ≥25 mm (OR=7.554, 95%CI 3.135-20.158, P=0.001), broad-based polyps (OR=5.676, 95%CI 1.153-9.596, P=0.002) and lesion located in the right hemicolon (OR=5.845, 95%CI 1.737-9.297, P=0.008) were independent risk factors of PPECS. Conclusions: The clinical features of PPECS in children are fever, abdominal pain and leukocytosis after the procedure. The lesion size ≥ 25 mm, broad-based polyps and lesion located in the right hemicolon are the independent risk factors of pediatric PPECS.
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