Gastric polypectomies in our department. Analysis of 198 specimens from 166 patients

Abstract

Background: 1–4% of patients who undergo gastric biopsy have gastric polyps. The two most common gastric polyps are the hyperplastic polyps which arise in patients with underlying gastritis and the fundic-gland polyps which are associated with long term PPI therapy. It has been reported that the risk of gastric polyp is increased in various colonic polyposis syndromes. The risk of colorectal adenocarcinoma increases significantly in patients with gastric cancer. Aims: To analyze the frequency of gastric polypoid lesions in our patient population and to evaluate association of gastric polyps with colon polyps. Materials and methods: Gastric polypectomies performed in our endoscopic department between January 2008 and December 2010 were analyzed restrospectively. We made 198 endoscopic polypectomies in 166 patients. Polypoid lesions were totally removed after infiltration with diluted epinephrine by loop, electrocauter or by hot biopsy forceps. In our patient population prevailed the female gender (116 females and 50 males). In some cases more than one polyp were removed in the same session, or subsequent polypectomies were performed at the controll gastroscopy in the same patient. The polyps were analyzed in many aspects (location, shape, size, histologic subtypes). It was also looked for that colonoscopy has ever made in these patients and the results of it were assessed. Results: The majority of polyps were located in the body of the stomach (105/198, 53%) and were sessile in form (178/198, 90%). More than half of the polyps were less than 5mm (105/198, 53%). The most common histology were hyperplastic polyp and fundic gland polyp (both 74/198, 37%). Other findings were chronic gastritis in 11 (6%), foveolar hyperplasia in 10 (5%), adenoma in 6 (3%), inflammatory polyp in 5 (3%) and neuroendocrine tumor in 7 (4%) cases. The histology were negative in 9 (5%) cases and in 2 patients histology sample was not taken. Colonoscopy was performed in 106 patients (63.9%) and colonic polyps were revealed in 29 patients (27.6%), colon cancers in 6 cases (5.7%). Conclusion: In our cases the hyperplastic and fundic gland polyps were most and equally frequent gastric polyps. We found in about one third of patients synchronous colonic polyps or tumors. In case of gastric polyp performing colonoscopy is mandatory.