Analysis Of Risk Factors For Bleeding Following Endoscopic Treatment Of Colorectal Polyps And Feature Analysis For Carcinogenesis Of Adenomatous Polyps

Objective:Our study was to investigate the clinical data?risk factors for bleeding following endoscopic treatment of colorectal polyps(Diameter ? 1cm)and feature analysis for carcinogenesis of adenomatous polyps.Method:It was analyzed retrospectively that the clinical data,endoscopic characteristics,risk factors for bleeding and features for carcinogenesis of adenomatous polyps in741 patients with a total of 884 colorectal polyps(Diameter ? 1cm)of our hospital from January 1,2014 to January 1,2016,which were resected under endoscope.Result:In the study of 741 patients,64 cases(8.6%)occurred complications,mainly included intraoperative bleeding in 16 cases(2.2%),delayed bleeding in 31 cases(4.2%);884 polyps mainly occurred in patients(a total of 629 cases,84.9%)over 40 years old;among them,480 cases were male(64.8%),the polyps whose diameters in the range of 1.0-1.9 cm were in the majority(63.0%);623 polyps(70.5%)were situated in rectum and sigmoid colon,721 polyps(81.5%)were adenomatous polyps,711polyps(80.4%)were with surface lobulated,530 polyps(60%)were mainly type I and type II of Yamada classification,538 polyps(60.8%)were treated by endoscopic mucosal resection(EMR).The bleeding rates of polyps diameters among 1.0-1.9cm,2.0-2.9cm,?3.0 cm were 3.6%,6.9%,10.8%.Univariate analysis of colorectal polyps resected under endoscope on intraoperative and delayed bleeding,we found that gender(P=0.017),location(P=0.011),size(P=0.004),lobulated or not(P=0.010),resection methods under endoscope(P=0.029)were statistically significant deviation between the two groups;taking the polyp as observation unit,multivariate logistic regression analysis of their clinical data and endoscopic characteristics,we found gender(P=0.012,OR=2.671,95% CI = 1.246-5.728)was an independent risk factor,men are more prone to bleeding than women;it was a protective factor for thelocation of polyps is sigmoid colon compared to rectum(P=0.011,OR=0.348,95%CI = 0.154-0.786),and it was a risk factor for the polyps whose diameters?3.0 cm compared to among 1.0-1.9 cm.Univariate analysis of the features for carcinogenesis of colorectal adenomatous polyps,we found that surface lobulated or not(P=0.001),surface smooth or not(P=0.017),Yamada classification(P=0.008)were statistically significant deviation,and the logistic regression analysis identified surface lobulation(P=0.001,OR=6.556,95% CI = 2.326-18.475)was an independent risk factor for carcinogenesis of adenomatous polyps.Conclusion:Resection of colorectal polyps under endoscope is a safe treatment method.Taking the polyp as observation unit,gender is an independent risk factor of colorectal polyps resected under endoscope on intraoperative and delayed bleeding,men are more prone to bleeding than women;the larger the diameters of polyps are,the higher the bleeding rates could be.Surface lobulation of colorectal adenomatous polyps are more likely lead to carcinogenesis.