Paris Sınıflamasına Göre Kolon Poliplerinde Polipektomi Tekniği Ve Histopatolojik Değerlendirme

Year 2024, Volume: 6 Issue: 2, 143 - 152, 30.06.2024

Aysun Yakut , Şeyma Büyücek , Mehmet Özcan , Mustafa Nacir

https://doi.org/10.52827/hititmedj.1457092

Abstract

Amaç: Kolorektal kanserler görülme sıklığı açısından üçüncü, mortalite açısından ise ikinci sırada yer almaktadır. Bu çalışmada kolonoskopi sırasında tespit edilen poliplerin Paris sınıflamasına göre tiplendirilmesi, uygun teknikle polipektomi yapılması, histopatolojik olarak sınıflandırılması, displazi varlığının belirlenmesi ve kolorektal kanser risk durumunun gözden geçirilmesi amaçlanmaktadır.
Gereç ve Yöntem: Çalışmamız, kolonoskopi sonucu kolonik polip saptanan, uygun teknikle polipektomi yapılan ve histopatolojik incelemesi tamamlanan 124 hastanın bir yıllık incelemesi olarak sunulan retrospektif bir çalışmadır.
Bulgular: Çalışma 2021-2022 yılları arasında %37,9’u kadın, %62,1’i erkek olmak üzere toplam 124 vaka ile gerçekleştirildi. Olguların yaş ortalaması 58,58 ± 14,40 yıldı. Poliplerin çıkarılma şekli polip boyutuna ve Paris sınıflamasına göre belirlendi. <5 mm polipler için biyopsi forsepsi ile polipektomi yapıldı. ≥5 mm’lik poliplerde salin-metilen mavisi-adrenalin ile mukoza ayrımı yapıldıktan sonra sıcak snare ile polipektomi yapıldı. İki adet çok büyük polip için parça parça polipektomi yapıldı. KRK sürveyansının ve displazi varlığının belirlenmesinde en önemli faktör polip çapıydı.
Sonuç: Kolorektal kanserler multifaktöriyeldir, başlangıç mimarisi poliplerdir. Bu poliplerin alınma tekniklerinden ziyade çaplarının artması kolorektal kanser riski açısından anlamlıydı.

Keywords

Kolon polibinde displazi varlığı, kolon polipleri, kolorektal kanser sürveyansı, polipektomi, polipektomi tekniği

Ethical Statement

Bu retrospektif çalışma Dicle Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylandı (Tarih: 09.06.2022, Sayı: 180).

Supporting Institution

Yok.

Thanks

Yok.

Polypectomy Technique and Histopathological Evaluation in Colon Polyps According to Paris Classification

Abstract

Objective: Colorectal cancers are in third place in terms of incidence and second in terms of mortality. This study aims to type the polyps detected during colonoscopy according to the Paris classification, perform polypectomy with the appropriate technique, classify them as histopathological, determine the presence of dysplasia, and review the risk status of colorectal cancer.
Material and Method: Our study is a retrospective study presented as a one-year review of 124 patients who were found to have colonic polyps due to colonoscopy, who underwent polypectomy with the appropriate technique, and whose histopathological determination was completed.
Results: The study was conducted between 2021 and 2022 with a total of 124 cases, 37.9% female and 62.1% male. The mean age of the cases was 58.58 ± 14.40 years. The way the polyps were removed was determined according to the polyp size and the Paris classification. Polypectomy was performed with biopsy forceps for <5 mm polyps. For ≥5 mm polyps, polypectomy was performed with a hotsnare after mucosal separation with saline-methylene blue-adrenaline. A piecemeal polypectomy was performed for two very large polyps. The most important factor in determining CRC surveillance and the presence of dysplasia was polyp diameter. The dysplasia rate in polyps removed with biopsy forceps was lower than in the polypectomy group with a hot snare.
Conclusion: Colorectal cancers are multifactorial, the initial architecture is polyps. The increase in the diameter of these polyps rather than the removal techniques was significant in terms of colorectal cancer risk.

Keywords

Colon polyps, colorectal cancers surveillance, presence of dysplasia in colon polyp, polypectomy, polypectomy technique

Ethical Statement

This retrospective study was approved by the Dicle University Faculty of Medicine Ethics Committee (Date: 09.06.2022, Number: 180).

Supporting Institution

None.

Thanks

None.

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