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Abstract: The patient was found to have multiple polyps in the stomach during physical examination for 7 years without any discomfort and was not treated. In recent January, he developed heartburn, acid reflux and other discomfort, and gastroscopy was performed to show multiple gastric polyps, and the pathology returned polyps in the gastric body and fundic glands. In order to seek further treatment, he was admitted to the hospital with multiple gastric polyps, and underwent gastroscopic gastric polyp electrosurgery. The pathology showed that the gastric body and fundic gland polyp were benign gastric tumors, and no other follow-up treatment was needed.
Basic information】Female, 65 years old
Disease Type】Benign tumor of the stomach
Hospital】Tianjin Fifth Central Hospital
Date of Consultation】January 2022
Treatment plan】Surgical treatment (painless gastroscopic gastric multiple polyps electrosurgery)
Treatment Period】3 days of hospitalization
Results】Gastric polyps were removed and the patient was discharged from the hospital
I. Initial consultation
The patient was found to have multiple gastric polyps on physical examination more than 7 years ago, without abdominal pain, bloating, nausea, vomiting and other discomforts, and was not treated. In recent month, he complained of heartburn, acid reflux and other discomfort, no nausea, vomiting, no abdominal pain, diarrhea, no chills, fever, gastroscopy showed multiple polyps in the gastric body and fundus, and the pathological return from biopsy showed gastrointestinal glandular polyps in the gastric body and fundus, and no abdominal abnormalities were found in the specialist examination. The patient was in good health, denied history of hypertension, diabetes, coronary artery disease, 7 years history of gastric polyp, no family history of gastric cancer. For further treatment, he was admitted to the hospital with multiple gastric polyps.
II. Treatment history
After admission, preoperative laboratory tests were completed, and no contraindication to surgery was found. One day before the operation, he ate a light and easily digestible diet, and fasted from food and drink for 12 hours before the operation. Preoperative intravenous anesthesia, intraoperative monitoring of vital signs was performed. Surgical steps: The patient was placed in the left lateral position, and the patient was confirmed to have multiple polyps distributed in the fundus and body of the stomach according to the conventional endoscopic insertion. After rinsing the mucus from the surface of the polyps and fully exposing them, the polyps were placed into the traps using an electrodesiccation trap close to the polyps, and the roots were tightened to avoid bleeding from the polyps caused by excessive force. The polyps were gradually removed by intermittent electricity. After observing the resected area and confirming no ulceration and bleeding, the polyp was removed and the mirror was retired, and the operation was finished. After the operation, the patient was instructed to gradually resume normal diet. The postoperative pathology was reported as glandular polyp without malignant tendency.
III. Treatment effect
When painless gastroscopy is performed, general anesthesia can make the patient sleep during the whole procedure and reduce the pain. High-frequency electrocoagulation resection mainly relies on the heat generated by high-frequency current to cut and cauterize the diseased tissues, which can play a radical role and can effectively inhibit recurrence after surgery. After the procedure, the patient’s heartburn, acid reflux and other uncomfortable symptoms disappeared. After 3 days, the patient resumed normal diet and had no task discomfort, and was discharged from the hospital. Since the polyps were benign, no follow-up treatment was required.
IV. Notes
We are glad that the patient is in remission after treatment, but it should be noted that although the patient has resumed normal diet at the time of discharge, he needs to pay attention to a light diet after discharge and should not consume spicy and stimulating food. In addition, studies have shown that smoking and drinking can damage the gastric mucosa, and chronic lesions of the mucosa can induce the formation of polyps, so patients should refrain from smoking and drinking after discharge. Moreover, patients can also take physical exercise according to their own condition, which is helpful to improve their physical fitness.
V. Personal insight
Gastric tumors are most common in gastric cancer, and benign tumors only account for about 2% of all gastric tumors. Benign gastric tumors are generally small in size and slow in development, with gastric sinus and gastric body as the most frequent sites. Gastric polyps are the most common clinical manifestation of benign gastric tumors, but it should be noted that gastric polyps are a morphological concept, which only refers to the raised lesions on the inner wall of the stomach in general, and there is no distinction between benign and malignant (although most of them are benign). They occur mostly in the middle-aged and elderly population aged 40-60 years, with the fundus and body of the stomach being the main sites of occurrence. For adenomatous polyps with malignant potential, most of them are located in the gastric sinus and are recommended to be removed surgically as soon as possible, or treated as gastric cancer by radical surgery if the polyp biopsy is malignant. If the polyp is benign like the patient, it is usually well treated after resection and no follow-up treatment is needed.