İstanbul Medical Journal (Aug 2021)
Diminutive Polyposis Coli: Should All Polyps be Removed during a Colonoscopy?
Abstract
Introduction:Colorectal cancer (CRC) is the second most common cause of cancer-related death. Most CRCs arise from colorectal polyps or adenomas. Colonoscopy with polypectomy offers a real-time management of benign adenomas, which breaks the adenoma-carcinoma sequence. In this study, the following question is discussed: should each polyp be excised in patients with more than three diminutive polyps?Methods:The study was conducted in Yedikule Surp Pırgiç Ermeni Hospital between January 2012 and October 2020. The medical records of 2,222 patients who underwent colonoscopy were retrospectively examined. The patients were divided into two groups. The first group included patients with three or fewer polyps, whereas the second group included patients with four or more polyps. In the first group, all polyps were excised regardless of the polyp’s diameter. In the second group, all polyps larger than 5 mm in diameter were excised. A maximum of three polyps were excised in patients who had more than three diminutive polyps. Student’s t-test, chi-square test, and Fisher’s exact test were used for the statistical analysis. All statistical analyses were performed using SPSS version 18.0 (SPSS Inc., USA). P<0.05 was considered statistically significant.Results:The total number of performed colonoscopies was 2,222. Colorectal polyps were detected in 501 (22.5%) patients. The number of total polypectomies was 728. Five hundred eighty-nine (81.0%) polyps had a diameter of 1 cm or less. Diminutive polyps were detected in 352 (48.4%) patients. The most common histopathological diagnosis in patients with diminutive polyps was tubular adenoma with mild dysplasia (60.8%) and inflammatory polyp (31.0%).Conclusion:It is concluded that excising all polyps encountered during colonoscopy is appropriate, whether they are diminutive or not. Further studies with a larger case series are needed in this area.
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