Humans ; Intestinal Polyps ; Colonic Polyps/surgery* ; Intestinal Polyposis ; Colorectal Neoplasms

Acolonic polyp is a circumscribed mass of tissue that projects above the surface of the intestinal mucosa, which may be classified as either pedunculated or sessile, depending on whether or not it contains a discrete stalk, and according to the size and type. It has been believed that colorectal cancer evolves from a precursor lesion, the adenomatous polyp. The introduction of colonoscopy in the early 1970s, followed by the demonstration of the feasibility of colonoscopic polypectomy, provided the technology for the application of this concept to clinical practice. Colorectal cancer can be prevented through examination of the entire colon and identification of a polyp to be resected. According to the National Polyp Study in the USA, the incidence of colorectal cancer is reduced by 76~90% following colonoscopic polypectomy. Colonoscopy and polypectomy, when performed by adequately trained physicians, is a safe and effective procedure that can decrease deaths resulting from colorectal cancer.
Adenomatous Polyps ; Colon ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Incidence ; Intestinal Mucosa ; Polyps*

OBJECTIVES: To study the clinical features of children with colorectal polyps and the efficacy of endoscopic treatment. METHODS: A retrospective analysis was performed on the medical data of 1 351 children with colorectal polyps who were admitted and received colonoscopy and treatment in the past 8 years, including clinical features and the pattern and outcomes of endoscopic treatment. RESULTS: Among the 1 351 children, 893 (66.10%) were boys and 981 (72.61%) had an age of 2-<7 years, and hematochezia (1 307, 96.74%) was the most common clinical manifestation. Of all the children, 89.27% (1 206/1 351) had solitary polyps, and 95.77% (1 290/1 347) had juvenile polyps. The polyps were removed by electric cauterization with hot biopsy forceps (6 cases) or high-frequency electrotomy and electrocoagulation after snare ligation (1 345 cases). A total of 1 758 polyps were resected, among which 1 593 (90.61%) were pedunculated and 1 349 (76.73%) had a diameter of <2 cm. Postoperative complications included bleeding in 51 children (3.77%), vomiting in 87 children (6.44%), abdominal pain in 14 children (1.04%), and fever in 39 children (2.89%), while no perforation was observed. The children aged <3 years had the highest incidence rates of postoperative bleeding and fever (P<0.0125), and the children with a polyp diameter of ≥2 cm had significantly higher incidence rates of postoperative bleeding, vomiting, and fever (P<0.05). CONCLUSIONS Solitary polyps, pedunculated polyps, and juvenile polyps are common types of pediatric colorectal polyps. Electric cauterization with hot biopsy forceps or high-frequency electrotomy and electrocoagulation after snare ligation can effectively remove colorectal polyps in children, with good efficacy and few complications. Younger age and larger polyp diameter are associated with a higher risk of postoperative bleeding.
Child ; Colonic Polyps/surgery* ; Colonoscopy ; Female ; Humans ; Intestinal Polyps/surgery* ; Male ; Retrospective Studies ; Vomiting

OBJECTIVETo investigate clinicopathological characteristics of colorectal sessile serrated adenoma/polyp (SSA/P) and its differential diagnosis from other serrated lesions.

METHODSClinicopathological features of all cases of colorectal serrated lesions from 5 209 colorectal biopsy samples at Shanghai Tongji Hospital from 2008 to 2013 were reviewed. Three hundred and fifty-three cases of serrated lesions were erolled in the study. Morphological features of SSA/P were investigated with an emphasis on histologic criteria for diagnosis and a literature review was performed.

RESULTSThree hundred and fifty-three cases of serrated lesions were identified, including 25 SSA/P (7.1%), 278 hyperplastic polyp (HP, 78.8%), and 44 traditional serrated adenoma (TSA, 12.5%). Twenty-five patients with SSA/P consisted of 16 males and 9 females with a mean age of 62.2 years (aged 34-84 years) and the lesions involved sigmoid colon (14 cases), ascending colon (9 cases), rectum (1 case) and transverse colon (1 case). Grossly, the majority of SSA/P was sessile with an averaged size of 0.73 cm. Histologically, typical SSA/P had elongated crypts with prominent serration and distorted crypts architecture. The detection rates of crypts dilatation and branching in SSA/P and HP were 100% (25/25) and 24% (12/50, P < 0.01), 72% (18/25) and 4% (2/50, P < 0.01), respectively. Morphological features observed only in SSA/P included L-shaped crypts (48%, 12/25), pseudo infiltration of mucosa muscle (16%, 4/25), atypical nuclei (32%, 8/25), and increased mucus secretion (24%, 6/25).

CONCLUSIONSSSA/P microscopically shows prominent serration and abnormal architectures of crypts. Complete tissue sectioning and correct embedding are helpful for the diagnosis. SSA/P without cytological dysplasia should be distinguished from HP, especially those with only a few distorted crypts.

Adenoma ; pathology ; China ; Colonic Polyps ; pathology ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Intestinal Polyps ; pathology ; Male ; Polyps ; pathology ; Rectal Neoplasms ; pathology

The 32 patients who suffered from rectal polyps and 49 healthy adults were quantified the circulate protein P53 and CEA which showed that the circular protein P53 increased in the elderly healthy persons compared with younger persons. In rectal polyp’s patients, the circular P53 noticeable changes than control group. The concentration of the P53 protein is more related to the polyp diameter. The concentration of the circular CEA related less to the age, the lesion of the polyp and to the early rectal cancer.
Intestinal Polyps

A study on 29 patients was laparoscopic diagnosed as gallbladder polyp has shown that gallbladder monopolyp (27.6%) and gallbladder multipolyps (72.4%). Polyps diameter of 5 mm, 5-10 mm and more than 10 mm were 55.2%, 34.5% and 10.3%, respectively. Polyps in the gallbladder cervix, gallbladder stem and gallbladder basal were 31%, 55.2% and 13.8%. Polyps type of increased sound (58.6%), type less sound (34.5%) and reduced sound (6.9%). The pedicular polyp (41.4%) and nonpedicular polyp (58.6%).
Gallbladder ; Polyps ; Intestinal Polyps

BACKGROUND/AIMS: There is a paucity of information on postpolypectomy surveillance currently practiced in Korea. Thus, we investigated the present state of postpolypectomy surveillance in Korea using a web-based survey. METHODS: A multiple choice questionnaire was used to determine the preferred surveillance modality, the colonoscopic surveillance interval used in 11 case scenarios, and clinical factors influencing surveillance intervals. The form was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians involved in a colonoscopy surveillance program. Of 425 colonoscopists contacted, 263 replied (response rate, 62%). Of the respondents, 94% were internists and 54% practiced in tertiary referral hospitals. RESULTS: All respondents chose colonoscopy as a preferred surveillance modality following polyp removal. Colonoscopy at 3 years was the most frequent answer after removal of 1 or 2 tubular adenoma(s) <1 cm in size, while 1 year was the most frequent answer after removal of an advanced adenoma or > or =3 adenomas, and 6 months was the most frequent choice after removal of adenoma with high-grade dysplasia or a sessile polyp > or =2 cm. The agreement rate for the time of first surveillance between preferred guideline recommendations and respondent answers was in the low range at 14-43%. CONCLUSIONS: A significant disagreement exists between current postpolypectomy surveillance practices of Korean colonoscopists and preferred guideline recommendations. This discrepancy may be due to the fact that the guidelines do not reflect recent studies and the specific medical environment in Korea. Thus, there is a need to develop new evidence-based Korean guidelines for postpolypectomy surveillance.
Adenoma ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Electronic Mail ; Humans ; Intestinal Diseases ; Korea ; Physicians, Primary Care ; Polyps ; Referral and Consultation ; Surveys and Questionnaires

To analyze the clinical and endoscopic characteristics of colorectal polyps in children, and to explore the detection rate, age and gender distribution characteristics, endoscopic treatment effect and follow-up monitoring of colorectal polyps in children, so as to provide reference for disease management of colorectal polyps in children. The clinical and endoscopic characteristics of children with colorectal polyps in Xi 'an Children's Hospital from January 2019 to December 2019 were retrospectively analyzed. The patients were divided into 5 groups according to age (y): 0t test, Pearson Chi-square test (χ²) were used to compare groups' differences. The results showed that a total of 724 colonoscopies were completed in 2019, and 160 colorectal polyps were diagnosed, with a detection rate of 22.10%. Among the children with colorectal polyps, 105 were males, accounting for 65.62%, and 55 were females, accounting for 34.38%. The detection rate of male colorectal polyps was 22.68%, and the detection rate of female colorectal polyps was 21.08%. There was no significant difference in the detection rate of colorectal polyps between males and females (χ² = 0.25, P =0.617). Children with colorectal polyps were most common in the age group of 1≤ y<4 years, 72 cases, accounting for 41.14%(72/175). The detection rate of colorectal polyps in different age groups was statistically significant (χ²=73.929, P<0.05). The main symptom of children with colorectal polyps was hematochezia, accounting for 87.5% (140/160). Colorectal polyps were mainly single polyps in 140 patients, accounting for 87.50%, 15 patients had 2-4 polyps, accounting for 9.38%, and 5 patients had 5 or more polyps, accounting for 3.12%. A total of 210 polyps were removed, and the most common site of polyps was rectum, 123 polyps, accounting for 58.57% (123/210). 111 (52.86%, 111/210) of them were 1 cm to 2 cm in diameter. The Yamada classification was mainly type Ⅲ, 114 pieces, accounting for 54.29% (114/210). Among the 210 polyps with diameter ≥0.5 cm, 165 were removed by endoscopic mucosal resection, accounting for 78.57% (165/210). There were 23 patients with postoperative complications, including hematochezia, abdominal pain, fever, vomiting, diarrhea, dizziness, and no gastrointestinal perforation. Juvenile polyps were the main pathological type, accounting for 88.13% (141/160). The children with juvenile polyps were followed up for 3-30 months, and recurrence was considered in 2 of them. In conclusion, the detection rate of colorectal polyps in children aged 1≤ y<4 years is high, and hematochezia is the main clinical manifestation. Standardized endoscopic treatment and follow-up monitoring are very important for children with colorectal polyps.
Child ; Child, Preschool ; Colonic Polyps ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage/complications* ; Humans ; Intestinal Polyps/surgery* ; Male ; Retrospective Studies

Colon ; pathology ; Colonic Polyps ; pathology ; Diagnosis, Differential ; Female ; Humans ; Intestinal Mucosa ; pathology ; Male ; Middle Aged

Colonic Polyps/surgery* ; Colonoscopy ; Colorectal Neoplasms/surgery* ; Humans ; Intestinal Polyposis ; Microsurgery ; Treatment Outcome