Polipektomia śródendoskopowa u dzieci

Józef Ryżko¹, Danuta Celińska-Cedro¹, Mikołaj Teisseyre¹, Marek Woynarowski¹, Andrzej Rasiński¹, Witold Bartnik², Eugeniusz Butruk²

Streszczenie
In years 1980-2000 polypectomy was carried out in 232 children (101 girls, 131 boys) aged 1,5-17 years. The reasons for hospitalisation were as follows: rectal bleeding (100%), abdominal pain (27%), mucous in stools (13%), obstipation (11%) and anaemia (9%).
In 176 children the procedures were carried out under general anaesthesia and in 56 – after intravenous premediaction.
Altogether 761 polyps were removed. Among them 745 were removed with diatermic snare in coloscopes CFLB3R and PCF 20 and 16 – with diathermic snare in rectoscopy Storz. 322 polyps were removed from rectum, 316 – from sigmoid colon, 51 – from colon descendent, 51 – from colon transversum and 21 polyp from colon ascendens. 431 polyps were smaller than 10 mm in diameter, 264 were between 10-19 mm, and 66 were bigger than 20 mm. In 202 children polyps were removed in 1 session, 11 children – 2 sessions, 4 children – 3 sessions and 15 children – 4 or more sessions. The histological examination revealed typical juvenile polyps in 220 children, adenoma – 3, hemangioma cavernosum – 1, teratoma – 1 and Peutz-Jeghers in 7 children. The rectal bleeding and other symptoms disappeared soon after polypectomy. We observed only 1 complication of polypectomy – perforation. 76 follow-up examinations (in a group of 81 children) were performed and no relapses of polyps nor new polyps were observed. Therefore we resigned of follow-up examination in children with 1-4 juvenile polyps.
Conclusions: 1. The endoscopic snare polypectomy is a safe and effective method of therapy of juvenile polyps. 2. This procedure should be carried out in a high specialised medical centre. 3. In children with 1-4 juvenile polyps the follow-up endoscopy is unnecessary.

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