RESUMEN
INTRODUCTION: The colonics polyps according to their number, size, location, age of presentation and mainly, according to their histology, have the potentiality of malignant degeneration, which makes of a continuous study and pursuit susceptible. OBJECTIVES: To evaluate the relation between the histologic type of the colon polyps, its location, the degree of dysplasia, the size, its possible commitment by carcinoma, the age, sex and the handling that has occurred them, in a series of 684 patients of the National Institute of Enfermedades Neoplásicas (INEN) between the 1 of January from 1974 to the 31 of March of the 2004. MATERIAL AND METHODS: The revision of clinical histories of 840 patients with the diagnosis of colon polyp was made who attended the service of Gastroenterology of the INEN between the 1 of January from 1974 to the 31 of March of 2004 and a card predesigned for each clinical history filled. The study is of observational, analytical type and of cross section. 1162 resecteds polyps evaluated themselves in this period. 156 patients by diagnosis related to cancer and familiar adenomatouspoliposis did not include themselves. The final sample was of 684 patients, in whom it was 1057 polyps. Other endoscopic findings were: internal hemorrhoids (172), colonic diverticulosis (50), anal fissure (4), and nonspecific ulcerative colitis (2). The statistical processing was made with program SPSS 12. For the qualitative variables the method of the Chi-square was used, for the quantitative variables analyzed the average, the rank and the variance. RESULTS: 1057 polyps extirpated, by means of the endoscopy polipectomy were 1016, with colectomy were 32 and with transanal resection without colectomy they 9. Within the histology of the 1057 polyps, 331 was briefed (31.3%) that were hyperplasic, 448 (42.4%) adenomas, 278 (26.3%) others and 35 (8.2%) adenocarcinomas on adenomas. The average age was of 50 years, was no significant difference with sex. The location but frequence of the adenomas was in the left colon (76.6%). Adenocarcinoma (carcinomas on adenomas), was present mainly in polyps villous type, with dysplasia severe and greater to 10 mm. Nevertheless, in smaller polyps of 5mm with dysplasia severe, was a polyp invaded by cancer, that represents the 0,8% of millimetric polyps. The made handling was mainly endoscopic, with 96% of the resected polyps this way, also slogan transanal resection and segmental colonic resection. The colectomy was necessary in 3% of all the made interventions, dysplasia severe or carcinoma was made in adenomatous polyps with, and in greater percentage in greater polyps of 20 mm (53%). The single polipectomy was sufficient in the level of invasion Haggitt 0. In patients with level of invasion Haggitt 1 and 2, the single polipectomy was the election treatment. On the other hand, in polyps with level of invasion Haggitt 3 and 4, the colectomy was the election treatment. One briefed two complications, one of perforation and peritonitis and another one of digestive hemorrhage loss (both: 0.29%), without mortality events. CONCLUSIONS: The Evaluation of colonic polyps in INEN is predominantly by endoscopy. The polyps are more frequent over the 50 years and have preferred location in the left colon. The carcinoma is more probable with severe dysplasia and greater size of the adenoma. All polyps, from the millimetric ones, including the hyperplasic, must be considered marks of neoplasia and extirpated in its totality.
Asunto(s)
Pólipos del Colon/patología , Pólipos del Colon/cirugía , Adolescente , Adulto , Anciano , Niño , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Introducción: Los pólipos colónicos de acuerdo a su número, tamaño, localización, edad de presentación y sobre todo, de acuerdo a su estirpe histológica, tienen la potencialidad de degeneración maligna, lo que los hace susceptibles de un continuo estudio y seguimiento. Objetivos: Evaluar la relación entre el tipo histológico de los pólipos de colón, su localización, el grado de displasia, el tamaño, su eventual compromiso por carcinoma, la edad, el sexo y el manejo que se les ha dado, en una serie de 684 pacientes del Instituto Nacional de Enfermedades Neoplásicas (INEN) entre el 1 de enero de 1974 al 31 de marzo del 2004. Material y métodos: Se realizó la revisión de historias clínicas de 840 pacientes con el diagnóstico de pólipo de colon que asistieron al Servicio de Gastroenterología del INEN entre el 1 de enero de 1974 al 31 de marzo de 2004 y se llenó una ficha prediseñada para cada historia clínica. El estudio es de tipo observacional, analítico y de corte transversal. Se evaluaron en este periodo 1162 pólipos resecados. No se incluyeron 156 pacientes por diagnóstico relacionado con cáncer y poliposis adenomatosa familiar. La muestra final fue de 684 pacientes, en los que se encontró 1057 pólipos. Otros hallazgos endoscópicos fueron: hemorroides internas (172), diverticulosis colónica (50), fisura anal (4), y colitis ulcerativa no específica (2). El procesamiento estadístico se realizó con el programa SPSS 12. Para las variables cualitativas se empleó el método de Chi-cuadrado, para las variables cuantitativas se analizaron la media, el rango y la varianza. Resultados: Se extirparon 1057 pólipos, mediante la polipectomía endoscópica fueron 1016, con uso de colectomía fueron 32 y con resección transanal sin colectomía fueron 09. Dentro de la histología de los 1057 pólipos, se consignaron 331 (31.3 por ciento) que fueron hiperplásicos, 448 (42.4 por ciento) adenomas, 278 (26.3 por ciento) otros y 35 (8.2 por ciento) adenocarcinomas sobre adenomas...
Introduction: The colonics polyps according to their number, size, location, age of presentation and mainly, according to their histology, have the potentiality of malignant degeneration, which makes of a continuous study and pursuit susceptible. OBJECTIVES: To evaluate the relation between the histologic type of the colon polyps, itslocation, the degree of dysplasia, the size, its possible commitment by carcinoma, the age, sex and the handling that has occurred them, in a series of 684 patients of the National Institute of Enfermedades Neoplásicas (INEN) between the 1 of January from 1974 to the 31 of March of the 2004. MATERIAL AND METHODS: The revision of clinical histories of 840 patients with the diagnosis of colon polyp was made who attended the service of Gastroenterology of the INEN betweenthe 1 of January from 1974 to the 31 of March of 2004 and a card predesigned for each clinical history filled. The study is of observational, analytical type and of cross section. 1162 resecteds polyps evaluated themselves in this period. 156 patients by diagnosis related to cancer and familiar adenomatouspoliposis did not include themselves. The final samplewas of 684 patients, in whom it was 1057 polyps. Other endoscopic findings were: internal hemorrhoids (172), colonic diverticulosis (50), anal fissure (4), and nonspecific ulcerative colitis (2). The statistical processing was made with program SPSS 12. For the qualitative variables the method of the Chi-square was used, for the quantitative variables analyzed theaverage, the rank and the variance. RESULTS: 1057 polyps extirpated, by means of the endoscopy polipectomy were 1016, with colectomy were 32 and with transanal resection without colectomy they 9. Within the histologyof the 1057 polyps, 331 was briefed (31.3 per cent) that were hyperplasic, 448 (42.4 per cent) adenomas,278 (26.3 per cent) others and 35 (8.2 per cent) adenocarcinomas on adenomas. The average age was of50 years, ...