Colonoscopic polypectomy results of our gastroenterology unit

Yıl 2011, Cilt: 10 Sayı: 3, 112 - 115, 01.12.2011

Ahmet Tarık Eminler Mustafa Sakallı Kader Irak Talat Ayyıldız Murat Keskin İsmail Yoğurt Macit Gülten Macit Gülten Murat Kıyıcı Selim Gürel Enver Dolar Selim Giray Nak

Öz

Background/aims: A tissue mass derived from mucosa or submucosa and extending into the lumen of the bowel is referred to as a polyp. Removal of polyps detected during colonoscopy and establishment of the pathological diagnosis are recommended since cancer has become the leading lesion and due to the potential cancer risk regardless of polyp size. In this study, we aimed to determine the prevalence of polyps and their histopathological results based on colonoscopies performed in our Unit. We aimed to reveal the polyp prevalence and histopathological results in our colonoscopy experience. Material and Methods: Colonoscopy reports between February 2005 and July 2010 were retrospectively reviewed from the endoscopy archive system in Uludag University, Endoscopy Unit, Department of Gastroenterology. Results: According to the colonoscopy reports, a total of 1379 polyps (22.06%) were detected in 894 patients; 914 of these polyps with attainable pathology results were analyzed. 530 of the patients (59.3%) were male and 364 (40.7%) were female. Of the polyps with neoplastic characteristics, 621 (68%) were tubular adenomas, 66 (7.2%) tubulovillous adenomas, and 5 (0.5%) villous adenomas. Conclusions: In this study, the prevalence of colon polyp types over an approximately six-year period was described in patients undergoing colonoscopy for various reasons in our Endoscopy Unit, which provides healthcare to an important part of the Eastern Marmara region. To determine the prevalence more clearly, especially for determination of prognosis in cases with dysplasia, additional wider and prospective studies are needed.

Anahtar Kelimeler

Colonoscopic polypectomy, adenomatous polyp, dysplasia

Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız

Öz

Giriş ve Amaç: Mukoza veya submukozadan köken alan ve barsak lümeni içine uzanan doku kütlesine polip denir. Kolonoskopi sırasında saptanan poliplerin boyutu ne olursa olsun kolorektal kanserin öncü lezyonu ya da potansiyel kanser riski nedeniyle çıkartılması ve patolojik tanısının konması önerilmektedir. Biz bu çalışmamızda bölümümüzde yapılan kolonoskopi sonuçlarında saptanan polip prevelansı ve bu poliplerin histopatoloji sonuçlarını ortaya koymayı amaçladık. Gereç ve Yöntem: Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalı Endoskopi Ünitesi'nde fiubat-2005 ile Temmuz-2010 arasındaki kolonoskopi raporları endoskopi arşiv sisteminden retrospektif olarak tarandı. Bulgular: Kolonoskopi raporlarına göre 894 hastada toplam 1379 adet polip (%22,06) tespit edildi. Bu poliplerden patoloji sonucuna ulaşılabilen 914 tanesi incelemeye alındı. Hastaların 530'u erkek (%59,3), 364'ü kadın (%40,7) idi. Neoplastik özellikte olan poliplerin 621 tanesi (%68) tubuler adenom, 66 tanesi (%7,2) tubulovillöz adenom, 5 tanesi de (%0,5) villöz adenom olarak saptandı. Sonuç: Bu çalışmada Doğu Marmara Bölgemizin önemli bir kesimine hizmet veren Endoskopi ünitemizde yaklaşık 6 sene boyunca çeşitli nedenlerle kolonoskopi yapılan hastalarımızdaki kolon polip tiplerinin prevelansı ortaya konmuştur. Prevelansın daha net belirlenmesi, özellikle displazi saptanan olgulardaki prognozun ortaya konması için daha geniş çapta ve prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Kolonoskopik polipektomi, adenomatöz polip, displazi

Kaynakça

• Itzkowitz SH, Potack J. Colonic Polyps and Polyposis Syndromes. In: Sleisenger MH, Fordtran JS, Eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philedeplhia. Saunders. P.2713-36.
• Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006;130:1872-85.
• Snover DC, Jass JR, Fenoglio-Preiser C, Batts KP. Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept. Am J Clin Pathol 2005;124:380-91.
• Heitman SJ, Ronksley PE, Hilsden RJ, et al. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009;7:1272-8.
• Jass JR, Sobin LH, Watanabe H. World Health Organization’s histological typing of intestinal tumours. A commentary on the second edition. Cancer 1990;66:2162-7.
• Konishi F, Morson BC. Pathology of colorectal adenomas: A colonoscopic survey. J Clin Pathol 1982;35:830-41.
• Carlsson G, Petrelli NJ, Nava H, et al. The value of colonoscopic surveillance after curative resection for colorectal cancer or synchronous adenomatous polyps. Arch Surg 1987;122:1261-3.
• Rex DK, Lehman GA, Hawes RH, et al. Screening colonoscopy in asymptomatic average-risk persons with negative fecal occult blood tests. Gastroenterology 372 1991;100:64-7.
• Williams AR, Balasooriya BA, Day DW. Polyps and cancer of the large bowel: a necropsy study in Liverpool. Gut 1982;23:835-42.
• Nam SY, Kim BC, Han KS, et al. Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes. Clin Gastroenterol Hepatol 2010;8:443-50.
• Nguyen SP, Bent S, Chen YH, Terdiman JP. Gender as a risk factor for advanced neoplasia and colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009;7:676-81.
• Lieberman DA, Holub JL, Moravec MD, et al. Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients. JAMA 2008;300:1417-22.
• O'Brien MJ, Winawer SJ, Zauber AG, et al. The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology 1990;98:371-9.
• Aslan S. Gastrointestinal Sistemin Polipleri In: Klinik Gastroenteroloji. Memik F. Editör. ‹stanbul. Nobel T›p Kitapevleri Ltd. 2004;512-29.