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Updated: Jul 5, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
[Risk factors for delayed bleeding after intestinal polypectomy in children]
Yue-Sheng Wang1, Jing Zhang1, Fu-Min Xue1
1Department of Gastroenterology, Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital, Zhenzhou 450018, China (Li X-Q, Email: lixiaoqinys@126. com).
Insights
Delayed bleeding after intestinal polypectomy in children is uncommon (3.22%). Key risk factors include longer operation time, larger polyp diameter, and specific resection methods, aiding surgical intervention decisions.
Area of Science:
- Pediatric Gastroenterology
- Surgical Oncology
- Clinical Research
Context:
- Intestinal polyps are common in children, necessitating effective and safe removal procedures.
- Delayed bleeding is a potential complication following endoscopic polypectomy, requiring careful management.
- Understanding risk factors is crucial for optimizing treatment strategies and patient outcomes.
Purpose:
- To identify clinical characteristics and risk factors associated with delayed bleeding after intestinal polypectomy in pediatric patients.
- To establish a predictive model for delayed bleeding using clinical and procedural variables.
- To provide evidence-based guidance for surgical intervention in pediatric intestinal polyp cases.
Summary:
- A retrospective analysis of 2,456 children undergoing endoscopic high-frequency electrocoagulation loop resection for intestinal polyps was performed.
- Delayed bleeding occurred in 3.22% of cases, with significant associations found for endoscopic operation time, polyp diameter, and resection method.
- Multivariate logistic regression and ROC curve analyses confirmed these factors as predictors of delayed bleeding.
Impact:
- The study highlights that endoscopic high-frequency electrocoagulation loop resection is associated with a low incidence of delayed bleeding in children.
- Identified risk factors (operation time, polyp diameter, resection method) can inform clinical decision-making and potentially reduce complication rates.
- Findings contribute to the theoretical basis for clinical surgical intervention of intestinal polyps in pediatric populations.
Objectives:
To investigate the clinical characteristics and risk factors of delayed bleeding after intestinal polypectomy in children, and to provide a theoretical basis for clinical surgical intervention of intestinal polyps.
Methods:
A retrospective analysis was conducted on the clinical data of 2 456 children with intestinal polyps who underwent endoscopic high-frequency electrocoagulation loop resection in the Endoscopy Center of Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. According to the presence or absence of delayed bleeding after surgery, they were divided into bleeding group with 79 children and non-bleeding group with 2 377 children. A multivariate logistic regression analysis was used to investigate the risk factors for delayed bleeding. The receiver operating characteristic (ROC) curve was used to investigate the value of various indicators in predicting delayed bleeding.
Results:
Of all 2 456 children, 79 (3.22%) experienced delayed bleeding, among whom 5 children with severe delayed bleeding underwent emergency colonoscopy for hemostasis and 74 received conservative treatment, and successful hemostasis was achieved for all children. There were significant differences between the bleeding and non-bleeding groups in age, body mass index, constipation rate, location of lesion, time of endoscopic procedure, resection method (P<0.05). Children with a diameter of polyps of 6-10 mm and >20 mm were more likely to develop delayed bleeding after resection (P<0.05). The multivariate logistic regression analysis showed that endoscopic operation time, polyp diameter, and resection method were significantly associated with delayed bleeding (P<0.05). The ROC curve analysis showed that the endoscopic operation time, polyp diameter, and resection method had a good value in predicting delayed bleeding after intestinal polypectomy, with an area under the ROC curve of 0.706, 0.688, and 0.627, respectively.
Conclusions:
Endoscopic high-frequency electrocoagulation loop resection has a lower incidence of delayed bleeding in children with intestinal polyps, and the endoscopic operation time, polyp diameter, and resection method are closely associated with the occurrence of postoperative delayed bleeding.
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