Do Multiple Adenomatous Gastric Polyps Require Surgery?

Q: Do Multiple Adenomatous Gastric Polyps Require Surgery?

Hello： If there are more than 2 cm polyps in the stomach, you can ask your doctor why endoscopic removal is not possible. <br>Is it due to a wide base or an excessive number of polyps, or is there a reason why mucosal resection cannot be performed? If none of these procedures can

Do multiple adenomatous gastric polyps require surgery?

Hello Dr.
Tsai,
I have a long history of gastroesophageal reflux disease (GERD) and superficial gastritis, and I have been undergoing periodic endoscopic surveillance and medication.
Over the past six months, I have noticed a worsening of these conditions, along with episodes of vomiting and gastric distension.
Two months ago, I switched to a different hospital for examination, and during the endoscopy, the doctor found multiple polyps in my stomach, each larger than 2 centimeters (the exact number was not specified).
Previous endoscopies did not report any polyps, with the last one being two years ago.
The biopsy report indicated adenomatous gastric polyps with ulceration.
The doctor recommended partial gastrectomy to prevent potential malignancy.

I would like to know if this surgical approach is too aggressive.
What are the risks associated with the surgery? After partial gastrectomy, will there be any impact on my ability to eat and absorb nutrients in the future? Thank you for your response.

Miss Hsieh, 40~49 year old female. Ask Date: 2017/03/30

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If there are more than 2 cm polyps in the stomach, you can ask your doctor why endoscopic removal is not possible.
Is it due to a wide base or an excessive number of polyps, or is there a reason why mucosal resection cannot be performed? If none of these procedures can be carried out, surgical intervention may be necessary, as adenomatous polyps need to be addressed to prevent potential malignancy.
The extent of gastric resection will affect food intake and nutrient absorption.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2017/03/30

More Info

When it comes to multiple adenomatous gastric polyps, the decision to proceed with surgery is often influenced by several factors, including the size, number, and histological characteristics of the polyps, as well as the patient's overall health and medical history. In your case, the presence of multiple gastric polyps larger than 2 cm, along with a biopsy report indicating adenomatous changes and ulceration, raises significant concerns.
Adenomatous polyps are considered precursors to gastric cancer, particularly when they exhibit dysplastic features. The risk of malignant transformation increases with the size of the polyp; thus, polyps larger than 2 cm are generally viewed with greater caution. The recommendation for partial gastric resection in your case is likely based on the need to mitigate the risk of cancer development, especially given the ulceration noted in the biopsy.

Surgical intervention, while it may seem aggressive, is often warranted in cases where there is a significant risk of malignancy. The risks associated with surgery can vary depending on the individual’s health status, the extent of the surgery, and the surgical technique employed. Generally, partial gastric resection is considered safe, but like any surgical procedure, it carries risks such as infection, bleeding, and complications related to anesthesia.
Post-operative effects on nutrition and eating habits can also be a concern. After partial gastric resection, patients may experience changes in gastric capacity and motility, which can affect how they tolerate food. Some individuals may need to adjust their diet, eat smaller meals, and be mindful of food choices to optimize digestion and nutrient absorption. However, many patients adapt well over time and can maintain a balanced diet.

In your situation, it is crucial to weigh the potential benefits of surgery against the risks. Consulting with a gastroenterologist and a surgeon who specializes in gastrointestinal procedures can provide you with a comprehensive understanding of your options. They can help assess the urgency of the situation, the likelihood of malignancy, and the best course of action tailored to your specific circumstances.

In summary, while surgery for multiple adenomatous gastric polyps may seem like a drastic measure, it is often a necessary step to prevent the potential progression to gastric cancer, especially given the size and characteristics of the polyps in your case. It is essential to have an open dialogue with your healthcare team to address your concerns, understand the risks involved, and make an informed decision about your treatment plan. Regular follow-up and monitoring will also be crucial in managing your condition effectively.

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