Kolonoskopik polipektomi sonuçlarımızın analizi

Yıl 2017, Cilt: 25 Sayı: 3, 66 - 69, 23.11.2017

Adil Coşkun , Altay Kandemir

https://doi.org/10.17940/endoskopi.356838

Cited By: 1

Öz

Giriş ve Amaç: Kolorektal poliplerin endoskopik olarak çıkarılması kolorektal kanser insidansını ve mortalitesini azaltabilir. Biz bu çalışmayı, endoskopi ünitemizde kolonoskopi ile tespit edilen poliplerin tip, boyut ve histopatolojik özelliklerini saptamak amacıyla yaptık. Gereç ve Yöntem: Adnan Menderes Üniversitesi Gastroenteroloji Bölümü Endoskopi Ünitesi’nde son dört yılda çeşitli endikasyonlarla kolonoskopi yapılan 18 yaş üzeri hastalar geriye dönük olarak değerlendirildi. Bulgular: Kolonoskopi yapılan toplam 3.953 hastanın 525’inde (%13.3) 808 adet polip tespit edildi. 525 hastanın 171’i (%32.6) kadın, 354’ü (%67.4) erkekti ve yaş ortalaması 62.8±11.4 idi. 808 polipten, 617 (%76.4) polip kolonun sol tarafında bulundu. En sık görülen bölge sigmoid kolondu (%25.2). Hastalar arasında, 454 hasta (%86.5) 50 yaşın üstündeydi ve 60-69 yaş grubunda (%35.6) polipler daha sık tespit edildi. Histopatolojik tipler temelinde, tübüler adenom [n = 604 (%74.8)] en sık rastlanan polipti ve adenokarsinoma 808 polip içinde 19’unda (%2.4) saptandı, 690 (%85.4) polipin boyutu 1 cm’den küçüktü. Sonuç: Kolon polipleri, kanser gelişim riski nedeniyle önemli bir sağlık problemi oluşturmaktadır ve kolon polipleri genellikle ileri yaşlarda saptanmaktadır. Bunların çoğunluğu kolonun sol tarafında bulunmakta, sıklıkla tübüler adenom tipinde, ve çapları 1 cm’ den daha azdır.

Anahtar Kelimeler

Kolorektal polipler, histopatoloji, lokalizasyon

Analysis of colonoscopic polypectomy results

Öz

Background and Aims: The endoscopic removal of colorectal polyps can reduce the incidence and mortality of colorectal cancer. We conducted this study to determine the type, size, and histopathological features of polyps detected using colonoscopy that was performed in our endoscopy unit. Materials and Methods: Patients aged more than 18 years who underwent colonoscopy due to various indications at Adnan Menderes University Department of Gastroenterology, Endoscopy Unit in the last 4 years were retrospectively evaluated. Results: A total of 808 polyps were detected in 525 (13.3%) of 3,953 patients who underwent colonoscopy. Of the 525 patients, 171 (32.6%) were females and 354 (67.4%) were males, with an average age of 62.8±11.4 years. Of the 808 polyps, 617 (76.4%) polyps were located in the left side of the colon. The most common site was the sigmoid colon (25.2%). Among the patients, 454 patients (86.5%) were aged more than 50 years, and polyps were more frequently detected among those in the age group of 60–69 years (35.6%). On the basis of the histopathological types, tubular adenoma was the most commonly detected polyp [n = 604 (74.8%)], and adenocarcinoma was detected in 19 (2.4%) of 808 polyps. The size of 690 (85.4%) polyps was less than 1 cm. Conclusion: Colon polyps constitute an important health problem due to the development of cancer, and colon polyps are usually found at older ages. The majority of these are found on the left side of the colon, frequently in tubular adenoma type, and less than 1 cm in diameter.

Anahtar Kelimeler

Colorectal polyps, histopathology, localization

Kaynakça

• 1. Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes. In:Sleisenger MH, Fordtran JS, (Eds). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10 th ed. Philedeplhia. Saunders. 2010; 2213-47. 2. Göral V. Kolorektal Polipler ve Polipozis Sendromları In: Klinik Gastroenteroloji ve Hepatoloji. Tözün N, Şimşek H, Özkan H, Şimşek İ, Gören A. Editör. İstanbul. MN Medikal & Nobel Ltd. 2007. 963-75. 3. Bond JH. Polyp guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Practice Parameters Committee of theAmerican College of Gastroenterology. Am J Gastroenterol. 2000; 95(11):3053-63. 4. Zauber AG, Winawer SJ, O’Brien MJ et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012; 366: 687-96. 5. Bretthauer M, Kaminski MF, Loberg M et al. Population- based colonoscopy screening for colorectal cancer: a randomized clinical trial. JAMA InternMed 2016; 176: 894-902. 6. Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ 2014; 348: g2467. 7. Rex DK, Kahi CJ, Levin B, et al. EPAGE II StudyGroup. Appropriateness of colonoscopy in Europe (EPAGE II). Surveillance after polypectomy and after resection of colorectal cancer. Endoscopy 2009; 41: 209-17. 8. Winawer SJ, Zauber AG, Fletcher RH, et al, US Multi-Society Task Force on Colorectal Cancer; American Cancer Society. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006;130:1872-85. 9. Pendergrass CJ, Edelstein DL, Hylind LM, et al. Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol 2008; 6:1011-5. 10. Markowitz AJ, Winawer SJ. Management of colorectal polyps. CA Cancer J Clin 1997; 47: 93-112. 11. Rex DK. Colonoscopy: A review of its yield for cancers and adenomas by indication. Am J Gastroenterol 1995; 90: 353-65. 12. Solakoğlu T, Atalay R, Köseoğlu H, et al. Analysis of 2222 colorectal polyps in 896 patients: A tertiary referreal hospital study. Turk J Gastroenterol 2014; 25: 175-9. 13. Korkmaz H, Kendir İC, Akkaya Ö. Kolon poliplerinin boyut, lokalizasyon ve histopatolojik yapılarının değerlendirilmesi. Endoskopi 2016;(24):13-7. 14. Eminler AT, Sakallı M, Irak K, et al. Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız. Akademik Gastroenteroloji Dergisi. 2011; 10: 112-5. 15. Corley DA, Jensen CD, Marks AR, et al. Variation of adenoma prevalence by age, sex, race, and colon location in a large population: implications for screening and quality programs. Clin Gastroenterol Hepatol. 2013;11:172-80. 16. Şahin A, Tunç N, Kılıç S, et al. Kolon polipleri sayı ve büyüklüğü malignite göstergesi olabilir mi? Endoskopi 2017;25:14-8. 17. Bas B, Dinc B, Oymaci E, et al. What are the Endoscopic and Pathological Characteristics of Colorectal Polyps? Asian Pac J Cancer Prev. 2015;16(13):5163-7. 18. Bernstein MA, Feczko PJ, Halpert RD, et al. Distribution of colonic polyps: increased incidence of proximal lesions in older patients. Radiology. 1985;155(1):35-8. 19. Ellidokuz E, Kundak I, Akpınar H et al. Kolorektal polip ve kanser lokalizasyonu arasındaki ilişki. Kocatepe Tıp Dergisi. 2003, 1, 49-53 20. Markowitz AJ, Winawer SJ. Management of colorectal polyps. CA Cancer J Clin 1997; 47: 93-112 21. Loeve F, Boer R, Zauber AG, et al. National Polyp Study data: Evidence for regression of adenomas. Int J Cancer 2004; 111: 633-9.