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

Yıl 2019, Cilt: 3 Sayı: 11, 809 - 811, 01.11.2019
https://doi.org/10.28982/josam.653586

Öz

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.

Kaynakça

  • 1. Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975:36;2251-70.
  • 2. 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.
  • 3. 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.
  • 4. Konishi F, Morson BC. Pathology of colorectal adenomas: A colonoscopic survey. J Clin Pathol. 1982;35:830-41.
  • 5. 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.
  • 6. Süleymanlar İ, Ertuğrul C, Işıtan F. Tanısal rektosigmoidoskopik incelemenin değerlendirilmesi. Turk J Gastroenterol. 1997;8(Suppl 1):28.
  • 7. 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.
  • 8. Williams AR, Balasoorriya BAW, Day DW. Polyp and cancer of the large bovel: A necropsy study in Liverpool. Gut. 1982;23:835-42.
  • 9. Altınparmak E, Sezgin O, Parlak E, Altıntaş E. Colorectal polyps ‘The Yüksek İhtisas experience’. Turk J Gastroenterol. 2001;12:49-52.
  • 10. Vatn MH, Staisberg H. The prevalence of polyps of the large intestine in Osio: An autopsy study. Cancer. 1982;49:819-25.
  • 11. Eminler AT, Sakallı M, Irak K, et al. Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız. Akademik Gastroenteroloji Dergisi. 2011;10:112-5.
  • 12. Granqvist S, Cabrielsson N, Sundelin P. Diminutive colonic polyps clinical significance and managemant. Endoscopy. 1979;11:36-42.
  • 13. 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.
  • 14. Bech K, Kronborg O, Fenger C. Adenomas and hyperplastic polyps in screening studies. World J Surg. 1991;15:7-13.
  • 15. Lieberman DA, Smith FW. Screening for colon malignancy with colonoscopy. Am J Gastroenterol. 1991;86:946-51.

Alt gastrointestinal sistem endoskopik polipektomi: Ardışık 7503 endoskopik işlem ile kesitsel çalışma

Yıl 2019, Cilt: 3 Sayı: 11, 809 - 811, 01.11.2019
https://doi.org/10.28982/josam.653586

Öz

Amaç: Kolonoskopik polipektomi klinik tıpta en etkili visseral kanser önleme aracıdır. Çalışmalarda kolonoskopik polipektomiyi takiben kolorektal kanser insidansında %76–90 bir azalma sağlandığı rapor edilmektedir. Bu çalışmada alt gastrointestinal sistem (GİS) endoskopi ile polipektomi uygulanan olgu serisini sunmak amaçlanmıştır.
Yöntemler: Çalışma evrenini genel cerrahi servisinde 2009-2019 yılları arasında tarama, tanısal ve takip amaçlı uygulanan 7503 alt GİS endoskopi (kolonoskopi veya rektosigmoidoskopi) işlemi oluşturdu. İncelemede polip tespit edilen ve polipektomi işlemi gerçekleştirilen 611 (%8,2) endoskopi işlemi değerlendirildi. Hastalar demografik veriler, klinik durum, histopatoloji raporları ve takipler açısından kayıt edildi.
Bulgular: Çalışma döneminde alt GİS endoskopi ile polipektomi işlemi 557 hastaya (38 hastada iki kez, 6 hastada üç kez olmak üzere) 611 işlem yapıldı. Hastaların 386’sı erkek, 226’sı kadın idi. Hastaların ortalama yaşı 57,3 (13,7) (aralık 24-89) idi. Tek endoskopi işleminde gerçekleştirilen biyopsi sayıları değerlendirildiğinde; 118 işlemde iki veya daha fazla olmak üzere toplam 813 polipektomi yapıldı. Polipektomi lokalizayonları değerlendirildiğinde; en sık rektum 233 (%29,5), sigmoid kolon 208 (%25,3) ve inen kolon 107 (%13) olduğu görüldü. Histopatolojik inceleme sonuçları değerlendirildiğinde; 25 (%4,1) adenokarsinom, 98 (%16) high grade displazi, 269 (%44) low grade displazi tespit edildi. Patolojiler arasında cinsiyet açısından fark tespit edilmedi ancak yaş açısından fark tespit edildi (sırasıyla p=0,098 ve p<0,001). Malign hastaların ileri yaşta (adenokanser (61,2(12,1)) ve high grade displazi (63,6(11,1))) ve benign hastaların daha genç yaşta (51,7(14,7)) olduğu görüldü. İlgili malign patolojiler için gerekli tedavi ve takipler gerçekleştirildi.
Sonuç: Alt GİS endoskopi yapılan hastaların %8,2’sinde polip görüldüğü ve bu poliplerin %20,1’inde ek tedavilere ve %44’ünde kontrol endoskopik takiplere gerek duyabileceği görülmektedir.

Kaynakça

  • 1. Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975:36;2251-70.
  • 2. 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.
  • 3. 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.
  • 4. Konishi F, Morson BC. Pathology of colorectal adenomas: A colonoscopic survey. J Clin Pathol. 1982;35:830-41.
  • 5. 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.
  • 6. Süleymanlar İ, Ertuğrul C, Işıtan F. Tanısal rektosigmoidoskopik incelemenin değerlendirilmesi. Turk J Gastroenterol. 1997;8(Suppl 1):28.
  • 7. 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.
  • 8. Williams AR, Balasoorriya BAW, Day DW. Polyp and cancer of the large bovel: A necropsy study in Liverpool. Gut. 1982;23:835-42.
  • 9. Altınparmak E, Sezgin O, Parlak E, Altıntaş E. Colorectal polyps ‘The Yüksek İhtisas experience’. Turk J Gastroenterol. 2001;12:49-52.
  • 10. Vatn MH, Staisberg H. The prevalence of polyps of the large intestine in Osio: An autopsy study. Cancer. 1982;49:819-25.
  • 11. Eminler AT, Sakallı M, Irak K, et al. Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız. Akademik Gastroenteroloji Dergisi. 2011;10:112-5.
  • 12. Granqvist S, Cabrielsson N, Sundelin P. Diminutive colonic polyps clinical significance and managemant. Endoscopy. 1979;11:36-42.
  • 13. 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.
  • 14. Bech K, Kronborg O, Fenger C. Adenomas and hyperplastic polyps in screening studies. World J Surg. 1991;15:7-13.
  • 15. Lieberman DA, Smith FW. Screening for colon malignancy with colonoscopy. Am J Gastroenterol. 1991;86:946-51.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma makalesi
Yazarlar

Fatih Başak 0000-0003-1854-7437

Yahya Kemal Çalışkan 0000-0003-1999-1601

Sırma Tilev 0000-0002-9606-3326

Abdullah Şişik 0000-0002-7500-8651

Yayımlanma Tarihi 1 Kasım 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 11

Kaynak Göster

APA Başak, F., Çalışkan, Y. K., Tilev, S., Şişik, A. (2019). Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. Journal of Surgery and Medicine, 3(11), 809-811. https://doi.org/10.28982/josam.653586
AMA Başak F, Çalışkan YK, Tilev S, Şişik A. Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. J Surg Med. Kasım 2019;3(11):809-811. doi:10.28982/josam.653586
Chicago Başak, Fatih, Yahya Kemal Çalışkan, Sırma Tilev, ve Abdullah Şişik. “Lower Gastrointestinal Endoscopic Polypectomy: Cross-Sectional Study With 7503 Consecutive Endoscopic Procedures”. Journal of Surgery and Medicine 3, sy. 11 (Kasım 2019): 809-11. https://doi.org/10.28982/josam.653586.
EndNote Başak F, Çalışkan YK, Tilev S, Şişik A (01 Kasım 2019) Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. Journal of Surgery and Medicine 3 11 809–811.
IEEE F. Başak, Y. K. Çalışkan, S. Tilev, ve A. Şişik, “Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures”, J Surg Med, c. 3, sy. 11, ss. 809–811, 2019, doi: 10.28982/josam.653586.
ISNAD Başak, Fatih vd. “Lower Gastrointestinal Endoscopic Polypectomy: Cross-Sectional Study With 7503 Consecutive Endoscopic Procedures”. Journal of Surgery and Medicine 3/11 (Kasım 2019), 809-811. https://doi.org/10.28982/josam.653586.
JAMA Başak F, Çalışkan YK, Tilev S, Şişik A. Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. J Surg Med. 2019;3:809–811.
MLA Başak, Fatih vd. “Lower Gastrointestinal Endoscopic Polypectomy: Cross-Sectional Study With 7503 Consecutive Endoscopic Procedures”. Journal of Surgery and Medicine, c. 3, sy. 11, 2019, ss. 809-11, doi:10.28982/josam.653586.
Vancouver Başak F, Çalışkan YK, Tilev S, Şişik A. Lower gastrointestinal endoscopic polypectomy: Cross-sectional study with 7503 consecutive endoscopic procedures. J Surg Med. 2019;3(11):809-11.