Cold snare polypectomy for fundic gland polyps

Abstract

Fundic gland polyps (FGPs), the most common type of gastric polyps, are thought to be sporadic or associated with an inherited polyposis syndrome. FGPs associated with familial adenomatous polyposis (FAP) or attenuated FAP may have increased risk of dysplasia or malignancy. We evaluated the characteristics of FGPs and the endoscopic management with cold snare polypectomy of patients with fundic gland polyposis. We retrospectively analyzed data collected from our executive health management center on patients who underwent esophagogastroduodenoscopy and colonoscopy between January 2016 and December 2018. Patients with FGPs ≧10 were considered as having polyposis. All patients with FGPs received cold snare polypectomy or biopsy. Patients' age, gender, polyp size, polyp location, Helicobacter pylori infection status with rapid urease test, presence of gastroesophageal reflux disease (GERD), histological type of polyps and colonoscopy results were recorded. Major complications, such as bleeding or perforation events, were reviewed. FGPs were found in 86 patients (83.7% women). The mean age was 48.4 ± 9.6 years. Twenty‐six patients with FGPs were classified as having fundic gland polyposis. Most polyps were located at the body and the fundus. The polyp sizes were 3 to 8 mm. No Helicobater pylori infection was found. Eighteen (20.9%) patients with FGPs had GERD. In all, 26 (30.2%) patients with FGPs also had colon polyps, one with colon cancer (pTis). Histology revealed one case (1.1%) with focal low‐grade dysplasia. No complications, such as bleeding or perforation episode, were found. In further analysis between adults with FGPs and fundic gland polyposis, there were statistical significant differences in age (P = .01) and GERD (P = .018). In logistic regression of multivariate analysis for risk factors associated with fundic gland polyposis, age (aOR: 1.059, P = .041) and GERD (aOR: 3.638, P = .026) were risk factors for fundic gland polyposis. FGPs are common and benign gastric polyps, with a good prognosis. Management can be observation in sporadic FGPs. Endoscopic resection may be considered in selected patients with FGPs, especially those with fundic gland polyposis, or FGPs associated with FAP or attenuated FAP. We used cold snare polypectomy for patients with fundic gland polyposis, which provides easy and effective endoscopic management without complications.

Safety of cold snare polypectomy vs conventional hot polypectomy for 4 to 10 mm gastric polyps: A single‐center retrospective study

“…HSP, by contrast, carries a small but more significant complication, DPPB, which is frequently related to damage to the submucosal layer caused by the electrocautery 20 . One recent study regarding CSP in gastric FGPs revealed no major complications such as delayed bleeding or perforation 21 . In the present study, DPPB did not occur in any patients who underwent CSP.…”

“…20 One recent study regarding CSP in gastric FGPs revealed no major complications such as delayed bleeding or perforation. 21 In the present study, DPPB did not occur in any patients who underwent CSP. As CSP is considered to be a safe procedure, it could be promising treatment for gastric polyps.…”

“…Second, to the best of our knowledge, there is no study addressing complications on gastric polypectomy between HSP and CSP. There were only limited studies ever reported low adverse effects in gastric polypectomy based on specific histology 21,27 . Our research provided more complete aspects regarding to the risk factors of gastric polypectomy.…”

“…There were only limited studies ever reported low adverse effects in gastric polypectomy based on specific histology. 21,27 Our research provided more complete aspects regarding to the risk factors of gastric polypectomy. A variety of risk factors were taken into consideration in the regression analysis.…”