Cumhuriyet Medical Journal

Öz

Abstract

Aim. Any discrete lesion protruding into the lumen of gastrointestinal tract detected by endoscopy is called as “polypoid lesion”. Thus, we aimed to study the demographic, clinical, and endoscopic characteristics of patients with gastric polypoid lesions. Method. Upper gastrointestinal system endoscopy was carried out in a total of 3375 patients between the dates of October 2006-July 2010. In 66 (1.95%) of these patients polypoid lesions were observed in various anatomical sites of the stomach, and polypectomy was performed. Sixty six patients who had gastric polyp or polpys were included in this study. The localization, size, histopathological findings and treatment of the polyps were recorded. All patients had at least one gastric polyp confirmed by histological examination. Results. The most frequent presenting symptom was epigastric pain (72.7%) followed by dyspepsia (18%), and anemia (4.5%). Fifty-one of the patients had one, 8 had two and 7 had three polyps. Out of 88 gastric polypoid lesions, 41 (46.5%) were located in the antrum followed by 26 (29.5%) in corpus, 12 (13.6%) in cardia, and 9 (10.4%) in around anastomoses. Fifty-three (60.2%) of the polyps were smaller than 1 cm, 23 (26.1%) were between 1-2 cm, and 12 (13.7%) were larger than 2 cm. In the histopathological examination of the polyps, 71 (80.7%) were found to be hyperplastic polyps, 15 (17%) were inflammatory polyps and 2 (2.3%) were adenomatous polyps. All patients with multiple polyps had only a single histological type. Conclusion. For this reason, endoscopic polypectomy to be a sensible diagnostic and therapeutic procedure of gastric polyps when feasible. Finally, endoscopic surveillance in these patients may be recommended to exclude both possibility of recurrence and cancer development elsewhere in stomach.

Keywords: Gastric polyp, hyperplastic polyp, inflammatory polyp, adenomatous polyp, polypectomy

Özet

Amaç. Endoskopik olarak görülen gastrointestinal sistemin lümenine çıkıntı oluşturan herhangi bir lezyon polipoid lezyon olarak adlandırılır. Çalışmamızda, gastrik polipoid lezyonlu hastaların demografik, klinik ve endoskopik özelliklerinin incelemeyi amaçladık. Yöntem. Ekim 2006 ile Temmuz 2010 tarihleri arasında toplam 3375 hastaya üst gastrointestinal sistem endoskopisi yapıldı. Bu hastaların 66 (%1,95)’sında midenin çeşitli anatomik pozisyonlarında polipoid lezyon görülerek bunlara polipektomi yapılmıştı. Gastrik polip tespit edilen 66 hastadaki gastrik polip ve/veya poliplerin lokalizasyon, boyut, histopatolojik bulguları ve tedavileri üzerinde duruldu. Tüm hastaların histolojik inceleme ile doğrulanmış en az bir polibi mevcuttu. Bulgular. Hastalarda görülen en sık şikayet %72,7 ile epigastrik ağrı daha sonra ise dispepsi (%18) ve anemi (%4,5) idi. Hastaların 51’inde bir adet, 8’inde iki ve 7’sinde üç adet polip mevcuttu. Toplam 88 adet gastrik polipoid lezyonun 41 (%46,5)’i antrumda, 26 (%29,5)’sı korpusta, 12 (%13,6)’si kardiada ve 9 (%10,4)’u anastomoz sahasında lokalize idi. Poliplerin 53 (%60,2)’ü 1 cm’den küçük, 23 (%26,1)’ü 1-2 cm arasında ve 12 (%13,7)’si 2 cm’den daha büyüktü. Poliplerin histopatolojik incelemesinde 71 (%80,7)’inde hiperplastik polip, 15 (%17)’inde inflamatuar polip ve 2 (%2,3)’sinde adenomatöz polip tespit edildi. Birden fazla polibe sahip hastaların tümü tek bir histopatolojik tipe sahipti. Sonuç. Endoskopik polipektomi gastrik poliplerin teşhis ve tedavisinde duyarlı bir yöntemdir. Sonuç olarak; gastrik polipli hastalarda hem nüks ihtimalini ortadan kaldırmak hemde midenin başka bir yerinde kanser gelişimini engellemek için endoskopi ile takip yapılmalıdır.

Anahtar sözcükler: Gastrik polip, hiperplastik polip, inflamatuar polip, adenomatöz polip, polipektomi