Low Risk of Neoplasia and Intraprocedural Adverse Events in Gastric Hyperplastic Polypectomy

Abstract

Goals: Assess neoplasia and polypectomy-related adverse event (AE) rates in gastric hyperplastic polyps (GHPs). Background: GHPs carry a risk of neoplastic transformation. The rate of neoplastic transformation and the risk of polypectomy-related bleeding are unclear in the West, as data are derived from Asian or small studies. The authors aimed to determine the rate of dysplasia and intraprocedural AEs in GHP polypectomies in a western cohort. Study: A retrospective study of 591 GHPs >1 cm resected in 491 patients in a single referral center on the occurrence of neoplasia and intraprocedural AEs. Results: The mean age was 74.9±11.1 years, 57% female individuals. The mean polyp size was 2±0.8 cm. There were 11 neoplastic polyps (1.9%) with low-grade dysplasia, high-grade dysplasia, and cancer in 7 (1.3%), 2 (0.3%), and 2 (0.3%), respectively. Neoplasia was associated with age [9 (3.2%) for more than 75 years vs. 2 (0.7%) for less than 75 years; P=0.035], but not with polyp size or gender. Fifty patients (8.5%) had intraprocedural bleeding (IPB) requiring endoscopic intervention, with 3 hospitalizations. There were no perforations or procedure-related deaths. IPB was associated with polyp size and neoplasia. The adjusted odds ratio (95% confidence interval) for IPB was 1.63 (1.2-2.2) for a 1 cm increase in polyp size, and 7.4 (1.9-29.6) for the presence of neoplasia. Conclusions: The neoplasia rate in GHPs was 1.9%, lower than most previous reports, with no major intraprocedural AEs. Physicians may consider biopsy and follow-up in frail elderly patients, but the safety of this strategy needs further confirmation.

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

“…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.…”

Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results

“…Therefore, it is necessary to take multiple biopsies of the intervening mucosa to ensure proper diagnosis and treatment. In the study by Bar et al, the malignant transformation rate for GHPs was 1.9%, which was lower than the literature [27]. Since the etiology of relapse is still unclear, long-term follow-up seems necessary to detect and treat relapses to prevent poor outcomes in cancer transformations.…”