Clinical characteristics and risk factors of post polypectomy electrocoagulation syndrome in children
10.3760/cma.j.cn112140-20200603-00572
- VernacularTitle:儿童肠息肉术后电凝综合征的临床特征及危险因素分析
- Author:
Yuesheng WANG
1
;
Jing ZHANG
;
Xiaoqin LI
;
Zhidan YU
;
Fang ZHOU
Author Information
1. 郑州大学附属儿童医院 河南省儿童医院消化科 450000
- Keywords:
Child;
Intestinal polyps;
Electrocoagulation;
Risk factors
- From:
Chinese Journal of Pediatrics
2021;59(3):201-205
- CountryChina
- Language:Chinese
-
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)×10 9/L vs. (8.5±1.2)×10 9/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.
