Endoskopik incelemede saptanan mide poliplerinin yerleşimi, histopatolojik tipleri ve tedavi yönetimi

Öz

Giriş ve Amaç: Gastrik polip lümene doğru çıkıntı oluşturan, mukoza veya submukozadan köken alan sesil ya da saplı lezyonlar olarak tanımlanır. Bu çalışmanın amacı, gastroskopi işlemi sırasında tespit edilen poliplerin görülme sıklığının, gastrik polip saptanan hastaların demografik özelliklerinin, poliplerin endoskopik ve histopatolojik özelliklerinin, eşlik eden diğer endoskopik bulguların ve tedavi şekillerinin değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmaya, Haziran 2017 ile Haziran 2020 tarihleri arasında üniversite hastanemiz gastroenteroloji bölümü endoskopi ünitesinde yapılan 13280 gastroskopi işleminde, polip saptanan 80 hasta dahil edildi. Seksen hastada toplam 125 polip saptandı ve retrospektif olarak değerlendirildi. Hastaların yaşı ve cinsiyeti, gastroskopi yapılma nedeni, polip sayısı, poliplerin midedeki lokalizasyonu, polipektomi yöntemi, polip histopatolojisi, Helicobacter pylori pozitifliği, intestinal metaplazi varlığı, atrofik gastrit varlığı, polipektomi sonrası komplikasyon gelişip gelişmediği tarandı. Bulgular: Seksen (%0.6) hasta ve bu hastalarda saptanan toplam 125 polip sonucu değerlendirildi. Hastaların 54’ü (%67.5) kadın ve yaş ortalaması 57.5 ± 12.5 yıldı. Hastaların %51.2’sinde endoskopi yapılma nedeni, başka merkezlerden kliniğimize polipektomi amacıyla yönlendirilmeleriydi. Mide mukoza örneklemesinde hastaların %11.3’ünde Helicobacter pylori pozitifliği, %20’sinde intestinal metaplazi, %21.2’sinde atrofik gastrit mevcuttu. Poliplerin %65.6’sında polip boyutu 10 mm’nin altındaydı. Polipler sırasıyla; en sık korpusta (%54.4), antrumda (%22.4) ve fundusta (%20.8) saptandı. Poliplerin histopatolojisi en sık fundik gland polip (%42.4), hiperplastik polip (%30.4) ve nöroendokrin tümördü (%20.8). En sık uygulanan polipektomi yöntemi poliplerin %51.2’sinde biyopsi forsepsi ile polipektomidir. Hastaların 5’inde (%4) polipektomi komplikasyonu olarak postpolipektomi interprosedürel kanama gelişti. Sonuç: Çalışmamızda mide polip saptanma oranı literatür ile uyumlu bulunmuştur. Endoskopik olarak bazen poliplerin birbirinden ayırt edilmesi zor olabildiğinden mümkün olan her polibe güvenli bir şekilde polipektomi yapılmalı ve komşu mide mukozasından örnekler alınmalıdır.

Anahtar Kelimeler

• Gastroskopi
• mide
• polip
• polipektomi
• Helicobacter pylori

Location, histopathological types, and treatment management of gastric polyps discovered during endoscopic examination

Öz

Background and Aims: Gastric polyps are sessile or pedunculated lesions originating from the mucosa or submucosa that protrude into the lumen. We sought to assess the occurrence of polyps discovered during gastroscopy, the demographic characteristics of patients with gastric polyps, the endoscopic and histopathological characteristics of polyps, other endoscopic observations, and treatment modalities. Materials and 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 hospital between June 2017 and June 2020. After discovering 125 polyps, the 80 patients were examined retrospectively. We recorded the age and gender 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 of atrophic gastritis, and presence or absence of complications after polypectomy. Results: We evaluated 80 out of 125 polyps (0.6%) found in these patients. Fifty-four (67.5%) patients were women and the mean age was 57.5 ± 12.5 years. Most patients (51.2%) were referred from other centers for polypectomy. According to the gastric mucosa sampling, 11.3% of the patients had positive Helicobacter pylori, 20% had intestinal metaplasia, and 21.2% had atrophic gastritis. The size of the polyp was less than 10 mm in 65.6% of the cases. Furthermore, polyps were most commonly found in the corpus (54.4%), antrum (22.4%), and fundus (20.8%). The most common histopathology of polyps were fundic gland polyps (42.4%), hyperplastic polyps (30.4%), and neuroendocrine tumors (20.8%). Polypectomy with biopsy forceps was the most common polypectomy method used (51.2%). Post polypectomy interprocedural bleeding occurred as a complication of polypectomy in 5 (4%) patients. Conclusion: The rate of gastric polyp discovery in our study was consistent with that in the literature. Because polyps can sometimes be difficult to distinguish endoscopically, polypectomy can be safely performed for any possible polyp and samples should be taken from the adjacent gastric mucosa.

Anahtar Kelimeler

• Gastroscopy
• gastric
• polyps
• polypectomy
• Helicobacter pylori

Kaynakça

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