上消化道息肉临床特征分析2 376例

Clinical and endoscopic features and endoscopic therapy of upper gastrointestinal polyps: An analysis of 332 cases

AIM: To analyze the clinical and endoscopic characteristics of upper gastrointestinal polyps in Qimen county, and to evaluate the efficacy of endoscopic therapy for upper gastrointestinal polyps.

METHODS: A total of 5037 cases who underwent gastroscopy at our hospital from April 2009 to April 2013 were retrospectively analyzed. Upper gastrointestinal polyps were observed gastroscopically. Part of upper gastrointestinal polyps was removed gastroscopically, and the specimens were subjected to pathological examination. Forty-four patients were followed for 3 to 36 mo.

RESULTS: A total of 332 patients with polyps were enrolled, including 146 (43.98%) males and 186 (56.02%) females. Approximately 64.46% of patients ranged in age between 40 and 60 years old. Of all patients enrolled, 88.5% had Yamata type I-II disease; 93.98% had polyps with a diameter < 1.5 cm; 75.9% (252) had single polyp, and 24.1% (80) had multiple polyps. The polyps were mainly located in the corpus and body (38.6%), antrum (32.8%), and duodenum (15.1%). Of 107 patients who underwent endoscopic therapy, all polyps were excised successfully once. During the follow-up period, 5 of 44 patients developed recurrent polyps, among whom 4 had multiple polyps.

CONCLUSION: Upper gastrointestinal polyps tend to occur in female patients between 40 and 60 years old. Single polyp, mainly found in the gastric antrum and fundus, occurs more often than multiple ones. Multiple polyps have a higher recurrence rate than single polyp. Endoscopic treatment is convenient, effective and safe for upper gastrointestinal polyps.

Surgical treatments for primary duodenal adenoma

AIM: To investigate the clinical features of and surgical options for duodenal adenoma.

METHODS: Clinical data for 18 patients with pathologically confirmed primary duodenal adenoma who underwent surgical treatment were retrospectively analyzed.

RESULTS: Of all patients, 5 had adenoma, 5 had Brunner's adenoma, 4 had villous tubular adenoma, 3 had villous adenoma, 1 had tubular adenoma; 10 had a tumor in the descending duodenum (including 4 cases near the nipple), 5 in the bulbar duodenum, 3 in the horizontal part; 11 underwent local tumor resection, 4 underwent pancreaticoduodenectomy, 1 underwent routine gastrectomy, 1 underwent partial excision of the duodenal papilla plus routine angioplasty, 1 underwent routine duodenal bowel resection, 1 underwent pancreaticoduodenectomy plus postoperative pancreatic fistula. Approximately 89% of patients were followed, and the follow-up duration was 6-91 mo. Two patients died of non-related disease, and one patient developed recurrence after local excision of villous adenoma.

CONCLUSION: The choice of surgical procedure for primary duodenal adenoma depends on the anatomical specificity and tumor histological type. Local excision is the preferred surgical approach with good prognosis.