Aralik 2021
Endoskopik incelemede saptanan mide poliplerinin yerlesimi, histopatolojik tipleri ve tedavi yönetimi
Location, histopathological types, and treatment management of gastric polyps discovered during endoscopic examination
- Ana Sayfa
- Sayılar
- Aralik 2021
- Endoskopik incelemede saptanan mide poliplerinin yerlesimi, histopatolojik tipleri ve tedavi yönetimi...
Özet
Giris ve Amaç: Gastrik polip lümene dogru çikinti olusturan, mukozaveya submukozadan köken alan sesil ya da sapli lezyonlar olarak tanimlanir. Bu çalismanin amaci, gastroskopi islemi sirasinda tespit edilenpoliplerin görülme sikliginin, gastrik polip saptanan hastalarin demografik özelliklerinin, poliplerin endoskopik ve histopatolojik özelliklerinin,eslik eden diger endoskopik bulgularin ve tedavi sekillerinin degerlendirilmesidir. Gereç ve Yöntem: Bu çalismaya, Haziran 2017 ile Haziran2020 tarihleri arasinda üniversite hastanemiz gastroenteroloji bölümüendoskopi ünitesinde yapilan 13280 gastroskopi isleminde, polip saptanan 80 hasta dahil edildi. Seksen hastada toplam 125 polip saptandive retrospektif olarak degerlendirildi. Hastalarin yasi ve cinsiyeti, gastroskopi yapilma nedeni, polip sayisi, poliplerin midedeki lokalizasyonu,polipektomi yöntemi, polip histopatolojisi, Helicobacter pylori pozitifligi,intestinal metaplazi varligi, atrofik gastrit varligi, polipektomi sonrasikomplikasyon gelisip gelismedigi tarandi. Bulgular: Seksen (%0.6) hasta ve bu hastalarda saptanan toplam 125 polip sonucu degerlendirildi. Hastalarin 54’ü (%67.5) kadin ve yas ortalamasi 57.5 ± 12.5 yildi.Hastalarin %51.2’sinde endoskopi yapilma nedeni, baska merkezlerdenklinigimize polipektomi amaciyla yönlendirilmeleriydi. Mide mukozaörneklemesinde hastalarin %11.3’ünde Helicobacter pylori pozitifligi,%20’sinde intestinal metaplazi, %21.2’sinde atrofik gastrit mevcuttu.Poliplerin %65.6’sinda polip boyutu 10 mm’nin altindaydi. Polipler si-rasiyla; en sik korpusta (%54.4), antrumda (%22.4) ve fundusta (%20.8) saptandi. Poliplerin histopatolojisi en sik fundik gland polip (%42.4),hiperplastik polip (%30.4) ve nöroendokrin tümördü (%20.8). En sikuygulanan polipektomi yöntemi poliplerin %51.2’sinde biyopsi forsepsiile polipektomidir. Hastalarin 5’inde (%4) polipektomi komplikasyonuolarak postpolipektomi interprosedürel kanama gelisti. Sonuç: Çalis-mamizda mide polip saptanma orani literatür ile uyumlu bulunmustur.Endoskopik olarak bazen poliplerin birbirinden ayirt edilmesi zor olabildiginden mümkün olan her polibe güvenli bir sekilde polipektomi yapilmali ve komsu mide mukozasindan örnekler alinmalidir
Abstract
Background and Aims: Gastric polyps are sessile or pedunculated lesions originating from the mucosa or submucosa that protrude into thelumen. We sought to assess the occurrence of polyps discovered duringgastroscopy, the demographic characteristics of patients with gastricpolyps, the endoscopic and histopathological characteristics of polyps,other endoscopic observations, and treatment modalities. Materialsand Methods: We included 80 patients who were found to have polyps during 13,280 gastroscopy procedures conducted in the endoscopy unit of the gastroenterology department of our university hospitalbetween June 2017 and June 2020. After discovering 125 polyps, the80 patients were examined retrospectively. We recorded the age andgender of the patients, reason for gastroscopy, number of polyps, localization of the polyps, polypectomy method, polyp histopathology, Helicobacter pylori positivity, presence of intestinal metaplasia, presence ofatrophic gastritis, and presence or absence of complications after polypectomy. Results: We evaluated 80 out of 125 polyps (0.6%) found inthese patients. Fifty-four (67.5%) patients were women and the meanage was 57.5 ± 12.5 years. Most patients (51.2%) were referred fromother centers for polypectomy. According to the gastric mucosa sampling, 11.3% of the patients had positive Helicobacter pylori, 20% hadintestinal metaplasia, and 21.2% had atrophic gastritis. The size of thepolyp was less than 10 mm in 65.6% of the cases. Furthermore, polypswere most commonly found in the corpus (54.4%), antrum (22.4%),and fundus (20.8%). The most common histopathology of polyps werefundic gland polyps (42.4%), hyperplastic polyps (30.4%), and neuroendocrine tumors (20.8%). Polypectomy with biopsy forceps was themost common polypectomy method used (51.2%). Post polypectomyinterprocedural bleeding occurred as a complication of polypectomyin 5 (4%) patients. Conclusion: The rate of gastric polyp discovery inour study was consistent with that in the literature. Because polypscan sometimes be difficult to distinguish endoscopically, polypectomycan be safely performed for any possible polyp and samples should betaken from the adjacent gastric mucosa
