Abstract
The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. Gastric polyps encompass a spectrum of pathologic conditions that can vary in histology, neoplastic potential, and management. Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. The goal of this review is to summarize clinical, endoscopic, and histopathologic features of various polyps, review syndromes associated with such polyps and provide management recommendations. The present study was carried out for analyzing and comparing the prevalence of neoplasia in polyps (Solitary and multiple) removed endoscopically from the esophagus, stomach, and bowel undergoing screening. Five years retrospective study was done on patients who underwent endoscopy procedures including Oesophagogastroduodenoscopy (OGD) and colonoscopybetween June 2015 and March 2019 in Faruk Medical City Hospital, Sulaimani City. Age and sex of patients, site of occurrence, number of polyps (solitary or multiple), and polyps' histologic type of 369 cases were analyzed in this study. Regarding solitary polyps, out of 279 polyps, 155 were neoplastic (55%) and 124 were non-neoplastic polyps, while multiple polyps, out of a total of 90 cases, 68 were neoplastic (75%) and 22 were non-neoplastic. More than 78% of patients were above the age of 40 years. Tubular adenoma was the most commonly diagnosed polyp. Large bowel was the most commonly involved site and left-sided polyps outnumbered right-sided ones with the sigmoid colon being the most commonly involved site. Screening programs including endoscopy, especially the colon for detecting polyps and particularly the colorectal region can be helpful to reduce morbidity and mortality of patients.
Highlights
Polyps are defined as any lesion or mass protruding into the lumen of hollow viscus at any site in gastrointestinal, respiratory, and genitourinary tracts and these usually arise from mucosal layers (1)
This study demonstrates various histologic types of polyps affecting different parts of the gastrointestinal tract like the small bowel, gastric and esophageal region, the main concern was focused on the nature of polyps located in the colorectal region due to their clinical significance and malignant potential
It has been noticed an elevated prevalence of GI polyps in patients above 40 years, the total number was 288 in both groups which is similar to the study of Amarapathy Sivasankar and Vajravelu Jayanthi (6) and Dakshitha et al (5) indicating that the prevalence of polyps increases with age and is well established all over the world (40)
Summary
Polyps are defined as any lesion or mass protruding into the lumen of hollow viscus at any site in gastrointestinal, respiratory, and genitourinary tracts and these usually arise from mucosal layers (1). Gastrointestinal polyps are regarded as common specimens in the field of surgical pathology. These polyps have a variable histologic spectrum but the major importance and significance among them are the premalignant adenomatous polyps due to their crucial association with adenocarcinoma (4) and among these, the colorectal polyps (CP) take the most importance and significance. They can be classified depending on their colonoscopic appearance as pedunculated (with stalks) or sessile (without a stalk), their morphological appearance (hyperplastic, adenoma, etc.), and their behavior (5). Incidence of developing changes of invasive carcinoma in a given polyp depends on the size and histologic type of the polyp, the risk of malignant changes rises with increasing severity of dysplasia in adenomatous polyps (6)
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