Endoscopic polypectomy: outcomes of 467 cases in 20 years

Authors: S. SELÇUK ATAMANALP, FUAT ŞENTÜRK, NESRİN GÜRSAN, GÜRKAN ÖZTÜRK, ABDUL MECİT KANTARCI, M. İLHAN YILDIRGAN, MAHMUT BAŞOĞLU

Abstract: Aim: Endoscopic polypectomy has an important place in the treatment of polyps—the preliminary lesions of colorectal cancers. This study aimed to discuss the outcomes of endoscopic polypectomy in 467 patients for 692 polyps over the course of 20 years. Materials and methods: The records of 692 endoscopic polypectomies performed in 467 patients between July 1988 and July 2008 were retrospectively evaluated. Results: Patient age ranged from 3 to 85 years (mean: 50.6 years), and 302 of the 467 (64.7%) patients were male. Polypectomy was performed for 692 polyps (mean: 1.5; range: 1-12). The most common polyp location was the rectum (41.5%), polyp diameter ranged between 1 and 40 mm (mean: 6.1 mm), and 451 of the polyps (65.2%) were pedunculated. In 2 (0.4%) patients, major complications developed, but there was no mortality. Histopathologically, 43.8% of the polyps were hyperplastic, 22.8% were adenomatous, 17.1% were mixed, 9.4% were hamartomas, 6.2% were serrated adenomas, and 0.7% were inflammatory polyps. The risk of malignant degeneration was significantly higher in patients with multiple polyps (P < 0.01), right colon polyps (P < 0.01), polyps larger than 10 mm (P < 0.01), sessile polyps (P < 0.01), and adenomatous polyps, mixed polyps, and serrated adenomas (P < 0.05). Of the 26 (5.6%) patients with malignant polyps, 6 in whom in situ and early carcinomas were detected were treated with polypectomy and followed-up with regular examinations. Another 20 patients with invasive carcinomas or familial polyposis were treated with surgery. Conclusion: Flexible endoscopic polypectomy is a simple and reliable method for removing colorectal polyps, and for treating in situ and early colorectal polypoid cancers.

Keywords: Endoscopy, polypectomy

Full Text: PDF