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Management of colorectal polyps in children
A Nagasaki1, K Yamanaka, T Toyohara
1Department of Surgery, Fukuoka Children's Hospital, Japan.
Insights
Colorectal polyps are common, with most patients experiencing hematochezia. Non-neoplastic polyps, primarily juvenile types, were successfully treated with minimal complications, showing no recurrences.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Colorectal polyps are a common clinical finding.
- Understanding their presentation and histology is crucial for patient management.
Purpose of the Study:
- To analyze the characteristics, symptoms, and treatment outcomes of colorectal polyps.
- To evaluate the safety and efficacy of transanal and endoscopic resection methods.
Main Methods:
- Retrospective analysis of 42 patients with colorectal polyps over 10 years.
- Data collection on polyp location, presenting symptoms, and treatment modalities.
- Histological classification of resected polyps.
Main Results:
- Most polyps (22/42) were located in the rectum.
- Hematochezia was the predominant symptom (29/42 patients).
- Non-neoplastic polyps (juvenile, inflammatory, hyperplastic) constituted the majority (36/42), with only one adenoma.
Conclusions:
- Colorectal polyps, predominantly non-neoplastic, can be effectively managed with transanal or endoscopic resection.
- These methods demonstrate a low complication rate and no observed recurrences in this cohort.
Abstract:
Forty-two patients each with a colorectal polyp have been treated in our hospital over the past 10 years. In twenty-two cases the polyps were noted in the rectum, nine in the sigmoid colon, seven in the descending colon and four in the transverse colon. Each patient had only one polyp. Hematochezia was the main symptom in 29 patients, prolapse of the polyp from the anus in 10, abdominal pain due to intussusception in two and no symptoms were observed in one. Auto-amputation of the polyp was considered to have occurred in five patients. Twelve rectal polyps were resected from a transanal operation, and another 25 polyps were removed endoscopically with electric cautery. We have had no experience of endoscopic complications such as bleeding or perforation. A histological examination revealed an adenoma in one patient. Other polyps were non-neoplastic and were classified as juvenile, inflammatory and hyperplastic in 30, two and four patients, respectively. There have been no recurrences of polyps to date.