Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures

Authors

Keywords:

Colonoscopic polypectomy, Adenoma, Adenocarcinoma

Abstract

Aim: Colonoscopic polypectomy is the most effective visceral cancer prevention tool in clinical medicine. Studies observed a 76-90% reduction in colorectal cancer incidence following colonoscopic polypectomy. We herein present a case series who underwent polypectomy by lower gastrointestinal system (GIS) endoscopy. Methods: The study population consisted of 7503 lower GIS endoscopy (colonoscopy or rectosigmoidoscopy) procedures performed in the Department of General Surgery between 2009 - 2019 for screening, diagnostic and follow-up purposes. 612 (8.2%) of the patients who underwent polypectomy were evaluated. The patients’ demographic data, clinical status, histopathology reports and follow-up findings were recorded. Results: During the study period, 612 patients (38 patients, twice and 3 patients, thrice) underwent polypectomy with lower GIS endoscopy. 386 of the patients were male and 226 were female. The mean age of the patients was 57.3 (13.7) (range 24-89) years. A total of 813 polypectomies were performed, and 118 procedures included two or more polypectomies. The most common sites of polypectomies were rectum (n=233, 29.5%), sigmoid colon (n=208, 25.3%) and the descending colon (n=107, 13%). Histopathological examination revealed 25 adenocarcinomas (4.1%), 98 high grade dysplasias (16%) and 269 low grade dysplasias (44%). In terms of histopathological results, there were no significant differences between genders (p=0.098), however, younger patients (mean age: 51.7 years (14.7)) were more likely to have benign results and malignity was more often encountered in older patients (p<0.001). The mean ages of patients with adenocarcinoma and high-grade dysplasia were 61.2 (12.1) and 63.6 (11.1) years, respectively. Necessary treatments and follow-ups were performed for the related pathologies. Conclusion: We observed that 8.2% of the patients undergoing lower GIS endoscopy had polyps and 20.1% of these polyps needed additional treatment, and 44% needed follow-up colonoscopy control. It should be noted that patients with various lower gastrointestinal tract symptoms may have malign polyps, potentially curable by polypectomy.

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References

Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975:36;2251-70.

Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993 Dec 30;329(27):1977-81.

Smith RA, Cokkinides V, Eyre HJ. American Cancer Society. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin. 2003;53:27-43.

Konishi F, Morson BC. Pathology of colorectal adenomas: A colonoscopic survey. J Clin Pathol. 1982;35:830-41.

Boland CR, Hzkowitz SH, Kim YS. Colonic polyps and gastrointestinal polyposis syndromes. Gastrointestinal disease, Sleisenger MH, Fordran JSS, Philadelphia, WB Saunders Company 1989;2:1483-518.

Süleymanlar İ, Ertuğrul C, Işıtan F. Tanısal rektosigmoidoskopik incelemenin değerlendirilmesi. Turk J Gastroenterol. 1997;8(Suppl 1):28.

O’Brien MJ, Winaver SJ, Zauber AG, et al. The National Polyp Study: Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterolgy. 1990;98:371-9.

Williams AR, Balasoorriya BAW, Day DW. Polyp and cancer of the large bovel: A necropsy study in Liverpool. Gut. 1982;23:835-42.

Altınparmak E, Sezgin O, Parlak E, Altıntaş E. Colorectal polyps ‘The Yüksek İhtisas experience’. Turk J Gastroenterol. 2001;12:49-52.

Vatn MH, Staisberg H. The prevalence of polyps of the large intestine in Osio: An autopsy study. Cancer. 1982;49:819-25.

Eminler AT, Sakallı M, Irak K, et al. Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız. Akademik Gastroenteroloji Dergisi. 2011;10:112-5.

Granqvist S, Cabrielsson N, Sundelin P. Diminutive colonic polyps clinical significance and managemant. Endoscopy. 1979;11:36-42.

DiSario JA, Fautch PG, Mai HD, et al. Prevalence and malignant potential of colorectal polyps in asymtomatic, avarage-risk men. Am J Gastroenterol. 1991;86:941-5.

Bech K, Kronborg O, Fenger C. Adenomas and hyperplastic polyps in screening studies. World J Surg. 1991;15:7-13.

Lieberman DA, Smith FW. Screening for colon malignancy with colonoscopy. Am J Gastroenterol. 1991;86:946-51.

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Published

2019-11-01

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Research Article

How to Cite

1.
Başak F, Çalışkan YK, Tilev S, Şişik A. Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. J Surg Med [Internet]. 2019 Nov. 1 [cited 2024 Mar. 29];3(11):809-11. Available from: https://jsurgmed.com/article/view/653586