[Therapeutic aspects of endoscopic polypectomy]

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Context:

• Endoscopic polypectomy is a common procedure for gastrointestinal polyps.
• The curative and prophylactic potential of polypectomy varies between the upper and lower gastrointestinal tracts.
• Histological analysis is crucial for determining the nature and management of resected polyps.

Purpose:

• To analyze the curative value of 466 endoscopic polypectomies in the upper and lower gastrointestinal tracts.
• To compare the therapeutic efficacy of polypectomies in different regions of the gastrointestinal tract.
• To evaluate the role of endoscopic polypectomy in diagnosing and treating gastrointestinal lesions.

Summary:

• In the upper GI tract (254 polypectomies), 4.3% had therapeutic value, with 2 carcinomas, 1 carcinoid, 5 bleeding polyps, and 4 prolapsing gastric polyps requiring intervention.
• In the lower GI tract (204 polypectomies), 56.3% had therapeutic value, including 16 focal/invasive carcinomas, 1 carcinoid, and 98 bleeding adenomas.
• 81.8% of lower GI polyps were adenomas (tubular, papillary, villous), supporting coloscopic polypectomy as a prophylactic and curative method against cancer.

Impact:

• Coloscopic polypectomy is a highly effective prophylactic and curative method for preventing colorectal cancer, based on the adenoma-carcinoma sequence.
• Endoscopic polypectomy in the upper GI tract primarily serves a diagnostic role, with limited therapeutic intervention rates.
• This study highlights the differential utility of endoscopic polypectomy, emphasizing its crucial role in colorectal cancer prevention and diagnosis in the upper GI tract.