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윤세옥,최홍열 대한소화기내시경학회 1981 Clinical Endoscopy Vol.1 No.1
Gastric polyp is a cincal term without any patholbgical significance: It refetes rileily to any benign; mucosal lesions that protrudes in to the gstrrc inmen, but conventral it includes a tnali$na:nt lesion which aeetns to lre degenerate'., Born benign ozte: Thz repoa^ted incidence of ga;strit pblyp is considera'ly increased ;recently, that is dues to rilainly to ntprovment of diagnostic fhod including gastric ersdoscop. Since 19'r'8, authors perform,md gastric enQoscopy in '2T74 cases an'd found gastrid cher in 352 cases, astric uRcers in 3s cases ana gatric poiyun 59 cases (2, 18), Gastric polyp ie more frequent in female: 3.0% of fe=rule and 1.6% of male xomined endtrscdpically. This sec ratio is in corytrst to that of stomach cancer where the male is prevalent eefiniteiy: The incidence of gastric polyp iicreaea in older ague groups: 6. 1% in the group of 70 or more years old, whereiis T.8'lo in the t3iird and fourth decade in gastroscopp: Clinically, about 70% of gartric polyps are found iri the distal stomach btic they are distriIiezted almost equally thsovgh aut the entire stomach inautopsy studies. I'n au$hbrs study; yvxs found in the antrum and 25% in the body. Gnly one of them was, found ih the fundus, Of the 59 cases, 53 cases had single polyp and 6 cases (11.7%) were multiple polyps. Endoscopically, 20 polyps were Yahiada type I, 30 polyas; Yarrida type , 9 polyps; type and 10 polyps; type j. Gastric polyps can be divided inta two groups: hyperl$gt;lastic polyps and adenonatou polyps: They are different in their malignant potentiality and the chance of association- with- the stomach cancer. Amontr the 46 cases biopsied, 8 cases (17.4%) were adenoinatous polyps and two of them were malignant. Gastric polyps can be diagnosed either by X-ray or endoscopy, or combined study. Gastroscopy is mare productive study not only far diagnosis of presence of polyps but also for differentiatioa from submucosal tumor and extrinsic compression. In authors study, only 16 cases (27.1 % ) were demonstrated by X-ray examination. Sine and stalk of the polyps are important factors for differentiation of malignancy from benign polyps. In our series, two of four polyps larger than 1. 5 cm in diameter were rnalignant, Treatment of gastric polyps are, either surgical or endoacopic. Because of great potential of malignancy in gastric polyps larger than 2 cm in diameter, they must be resected, preferable by subtotal gastrectomy. However, benign, district, small gastric polyps can be treated bysimple polypectomy or wide exision of polyps and underlying gastric wall. Endoscopic polypectomy using diathermy is simple and valuable technique for the biopsy in toto and treatment of small gastric polys. Surgery can be avoided in some elderly and poor risk patient with polypoid malignant lesions by this technique. Recent advances in endoscopic technique can afford to follow up the course of small benign gastric polyps periodically, without any treatment.Treatment of gastric polyps are, either surgical or en.doacopic. Because of great potential of malignancy in gastric polyps larger than 2 cm in diameter, they must be resected, preferable by subtotal gastrectomy. However, benign, district, small gastric polyps can be treated bysimple polypectomy or wide exision of polyps and underlying gastric wall. Endoscopic polypectomy using diathermy is simple and valuable technique for the biopsy in toto and treatment of small gastric polys. Surgery can be avoided in some elderly and poor risk patient with polypoid malignant lesions by this technique. Recent advances in endoscopic technique can afford to follow up the course of small benign gastric polyps periodically, without any treatment.