Endoscopic gastroduodenal polypectomy

Abstract

The authors performed a total of 288 successful endoscopic gastroduodenal polypectomy procedures in 129 patients. Drawing on literary data and the results of follow-up of their own patients, they regard endoscopic gastroduodenal polypectomy as a successful and relatively low-risk method for secondary prevention of gastric cancer. Recurrence of adenomas, with malignant degeneration in 6-75%, was noted, only in the first year after primary polypectomy, in 8% of patients. Four percent of patients after adenoma polypectomy developed gastric carcinoma. Removal of gastroduodenal adenomas by endoscopy represents a final therapeutic procedure significantly reducing the possibility of these originally benign variants transforming into malignant ones. Even polyps smaller than 10 mm in diameter may be adenomas possessing a rather high malignant potential. The authors regard endoscopic polypectomy of hyperplastic polyps as a justified procedure since the literary data compiled and their own experience suggest polyp susceptibility to development of dysplasia. While this tendency gets manifest only rarely, it would be medically wrong to dismiss it as negligible. In case of removal of an early polypoid gastric carcinoma, endoscopic polypectomy is a therapeutic procedure only in clearly defined and histologically well classified cases. In other cases involving prominence of the gastroduodenal mucosa, it is an invaluable diagnostic method whose benefit is that it removes an entire polyp for histologic examination.