RESUMO
AIM: The aim of this study was to report the anatomical location and histologic type of colorectal polyps in a large series of Iranian patients that attended for colonoscopy. BACKGROUND: Polyps that develop through the adenoma-carcinoma pathway are considered neoplastic and may eventually progress to invasive carcinomas. In addition polyps can develop with no neoplastic potential. These neoplastic and non-neoplastic polyps can be identified and removed at colonoscopy. PATIENTS AND METHODS: In this retrospective study, the medical records of patients who had attended for colonoscopy were reviewed. Patient demographics and colonoscopy findings were reviewed. The anatomical location, macroscopic appearance and histological assessment of any polyps were recorded. RESULTS: 716 patients' records were reviewed. 437 patients (61 %) were male and 279(39%) were females. The mean patient age was 55.3 yr (18-89 yr). A total of 936 polyps were identified. 779 (83.3%) were neoplastic and 157(16.7%) polyps were non-neoplastic.727 of the polyps were adenomatous. Of the 727 adenomatous polyps: 198(27.2%) were in sigmoid, 156(21.24%) were in caecum and ascending colon, 153(21%) were in descending colon, 131(18%) were in transverse colon and 89(12.3%) were in rectum. 39.5% of adenomas were proximal to the splenic flexure. Carcinoma was observed in 52 cases. 18 carcinomas (34.5%) were left sided and 34 (65.5% of carcinomas) were right sided. Of the 716 patients, 179 patients (25%) had synchronous lesion(s). CONCLUSION: A significant number of adenomas and carcinomas lie proximal to the splenic flexure and occur in the absence of distal lesions. These lesions would be missed if the distal colon was examined and the entire colon examined only if a distal lesion was identified.
RESUMO
BACKGROUND & AIM: Colon polyps are important lesions and a concern because of the potential for colorectal cancer. Colorectal carcinoma is one of the most common causes of cancer-related deaths in Iranian population. The distribution of polyps in the colon may affect the efficacy of a screening modality. The aim of this study was to determine clinical & pathology characteristics of colorectal polyps in Iranian population. MATERIAL & METHODS: In this study is cross sectional survey that 856 polypectomies were done in 716 patients. Anatomical distribution, size and histopathology of polyps were described in 2004 - 2008 in the educational hospital of Taleghani in Tehran. RESULTS: polyps were observed in 437 males and 279 females and gastroenterologists did colonoscopic polypectomy. 3.12 percent of polyps were located in the rectum, 19.6 percent in sigmoid, 24.4 percent in descending colon, 13.9 percent in transverse colon, 29.6 percent were in cecum and ascending colon. 77 (9%) polyps were non-neoplastic and 779 (91%) were neoplastic. Adenomas were present in 727 (85%) cases, of these 411 (56% of adenomas) were left-sided and 316 (44% of adenomas) were right-sided. Carcinoma was observed in 52 cases, of these 18 (34.5%) were left sided and 34 (65.5% of carcinomas) were right sided. Of them 354 were advance polyp (> 1 cm, villous type, high grade dysplasia). 87 (34%) of Advance polyps were in under 50 year patients and 149 (58.6%) were right sided. CONCLUSION: This study has shown that a significant number of adenomas and carcinomas lie proximal to the splenic flexure. Thus, in the absence of left-sided lesions, it is expected that examination of the colon limited to the splenic flexure would miss 44% of such lesions. The increasing right-sided prevalence of these lesions with age suggests that evaluation of the proximal bowel is particularly important in older people. In addition there were higher stages of dysplasia and malignancy in larger polyps.
