[Clinical characteristics and risk factors of post polypectomy electrocoagulation syndrome in children].

Zhonghua Er Ke Za Zhi

Department of Gastroenterology, Children's Hospital Affiliated to Zhengzhou University, Children's Hospital of Henan Province, Zhengzhou 450000, China.

Published: March 2021

To study the clinical characteristics and risk factors of post polypectomy electrocoagulation syndrome (PPECS) in children. 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. 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) (24±8) min, =18.086, 0.01), the rate of piecemeal resection (78.3% (18/23) 17.4% (20/115), =17.358, 0.01), the lesion size ((38.4±3.7) . (15.8±4.3) mm, =15.127, <0.01), the proportion of polyps located in the right hemicolon (47.8% (11/23) 23.5% (27/115), =7.035, 0.05), and the proportion of broad-based polyps (78.3% (18/23) 25.2% (29/115), = 29.259, 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/L (8.5±1.2)×10/L, =6.085, 0.05) and C-reactive protein ((25.8±3.6) (1.1±0.6) mg/L, =5.531, 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 (=7.554, 95% 3.135-20.158, 0.001), broad-based polyps (=5.676, 95% 1.153-9.596, 0.002) and lesion located in the right hemicolon (=5.845, 95% 1.737-9.297, 0.008) were independent risk factors of PPECS. 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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http://dx.doi.org/10.3760/cma.j.cn112140-20200603-00572DOI Listing

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