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Endoscopic diode laser therapy for gastric hyperplastic polyps in cirrhotic patients

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Abstract

Purpose Endoscopic polypectomy to remove gastric hyperplastic polyps in cirrhotic patients is associated to a high risk of postprocedural bleeding. The current study set out to examine the effect of diode laser therapy used to treat this type of polyps in cirrhotic patients. Methods This single-center study retrospectively examined the data of cirrhotic patients with macroscopic bleeding or anemia who underwent diode laser therapy (940 nm wave length, 30-W power setting in continuous mode) to remove histology-confirmed hyperplastic gastric polyps. Results A total of 222 polyps (mean diameter 10 ± 8 mm) were treated in 55 patients who were included in the study. No complications such as bleeding or perforations were reported. After a mean of 5 ± 4 sessions, 31 patients (56%) were completely healed. In 16 patients (29%), there was only a partial response (mean polyp reduction diameter of 64 ± 15%), while 8 (15%) patients did not respond to treatment. Statistically significant better results were noted in the patients who underwent ≥ 2 laser sessions. Hemoglobin levels and number of blood transfusions required were not statistically different after treatment. After a mean study period of 21 ± 17 months, polyp recurrences were noted in 11 patients (20%), but none of the polyps had degenerated. Conclusion Diode laser therapy was found to be a safe treatment for hyperplastic polyps in cirrhotic patients. Due to the presence of others bleeding lesions in cirrhotic patients, this treatment did not have an impact on anemia and transfusion requirements.

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References

  1. De Lisi S, Peralta S, Arini A, Simone F, Craxì A (2011) Oesophagogastroduodenoscopy in patients with cirrhosis: extending the range of detection beyond portal hypertension. Dig Liver Dis 43:48–53

    Article  Google Scholar 

  2. Nelson M, Ganger D, Keswani R, Grande D, Komanduri S (2016) Endoscopic resection is effective for the treatment of bleeding gastric hyperplastic polyps in patients with and without cirrhosis. Endosc Int Open 4:E874–E877

    Article  Google Scholar 

  3. Al-Haddad M, Ward EM, Bouras EP, Raimondo M (2007) Hyperplastic polyps of the gastric antrum in patients with gastrointestinal blood loss. Dig Dis Sci 52:105–109

    Article  Google Scholar 

  4. Amarapurkar AD, Amarapurkar D, Choksi M, Bhatt N, Amarapurkar P (2013) Portal hypertensive polyps: distinct entity. Indian J Gastroenterol 32:195–199

    Article  Google Scholar 

  5. Lam MC, Tha S, Owen D et al (2011) Gastric polyps in patients with portal hypertension. Eur J Gastroenterol Hepatol 23:1245–1249

    Article  Google Scholar 

  6. Cheesman AR, Greenwald DA, Shah SC (2017) Current management of benign epithelial gastric polyps. Curr Treat Options Gastroenterol 15:676–690

    Article  Google Scholar 

  7. Polese L, Marini L, Rizzato R, Picardi E, Merigliano S (2018) Endoscopic diode laser therapy for chronic radiation proctitis. Lasers Med Sci 33:35–39

    Article  Google Scholar 

  8. Polese L, Angriman I, Pagano D et al (2006) Laser therapy and surgical treatment in transfusion-dependent patients with upper-gastrointestinal vascular ectasia. Lasers Med Sci 21:140–146

    Article  Google Scholar 

  9. Polese L, Angriman I, Scarpa M et al (2011) Diode laser treatment of Barrett’s esophagus: long-term results. Lasers Med Sci 26:223–228

    Article  Google Scholar 

  10. Norberto L, Polese L, Angriman I, Erroi F, Cecchetto A, D'Amico DF (2005) Laser photoablation of colorectal adenomas: a 12-year experience. Surg Endosc 19:1045–1048

    Article  CAS  Google Scholar 

  11. Shaib YH, Rugge M, Graham DY, Genta RM (2013) Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol 11:1374–1384

    Article  Google Scholar 

  12. Li WB, Zuo XL, Zuo F et al (2010) Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy. Surg Endosc 24:517–524

    Article  Google Scholar 

  13. Goddard AF, Badreldin R, Pritchard DM, Walker MM, Warren B, British Society of Gastroenterology (2010) The management of gastric polyps. Gut 59:1270–1276

    Article  Google Scholar 

  14. Vatansever S, Akpınar Z, Alper E et al (2015) Gastric polyps and polypoid lesions: retrospective analysis of 36650 endoscopic procedures in 29940 patients. Turk J Gastroenterol 26:117–122

    Article  Google Scholar 

  15. Enestvedt BK, Chandrasekhara V, Ginsberg GG (2012) Endoscopic ultrasonographic assessment of gastric polyps and endoscopic mucosal resection. Curr Gastroenterol Rep 14:497–503

    Article  Google Scholar 

  16. Marsteller WF, Lewin DN, Reuben A (2012) The biopsy GAVE the diagnosis. Clin Gastroenterol Hepatol 10:e75–e76

    Article  Google Scholar 

  17. Boyd JT, Lee L (2014) Portal hypertension-associated gastric polyps. BMJ Case Rep. https://doi.org/10.1136/bcr-2013-202312

  18. Pai CG (2013) Portal hypertensive polyp--what is in a name? Indian J Gastroenterol 32:163–164

    Article  Google Scholar 

  19. Elhanafi S, Saadi M, Lou W et al (2015) Gastric polyps: association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study. World J Gastrointest Endosc 7:995–1002

    Article  Google Scholar 

  20. Panackel C, Joshy H, Sebastian B, Thomas R, Mathai SK (2013) Gastric antral polyps: a manifestation of portal hypertensive gastropathy. Indian J Gastroenterol 32:206–207

    Article  Google Scholar 

  21. Fleischer D (1984 May) Lasers and gastroenterology. Am J Gastroenterol 79:406–415

    CAS  PubMed  Google Scholar 

  22. Joffe SN, Schröder T (1987) Lasers in general surgery. Adv Surg 20:125–154

    CAS  PubMed  Google Scholar 

  23. Cheong SM, Sun DJ, Rim KS (1986) Endoscopic Nd-YAG laser therapy for gastric polyp. Korean J Intern Med 1:222–228

    Article  CAS  Google Scholar 

  24. Janda P, Sroka R, Baumgartner R, Grevers G, Leunig A (2001) Laser treatment of hyperplastic inferior nasal turbinates: a review. Lasers Surg Med 28:404–413

    Article  CAS  Google Scholar 

  25. Gonzalez-Casas R, Jones EA, Moreno-Otero R (2009) Spectrum of anemia associated with chronic liver disease. World J Gastroenterol 15:4653–4658

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Authors are grateful to Linda Inverso for English revision of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Oncology and Gastroenterology, Third Surgical Unit, University of Padova, Padua, Italy

    Lino Polese, Carlotta La Raja & Stefano Merigliano

  2. Clinica Chirurgica 3, Policlinico Universitario 6 Piano, Via Giustiniani 2, 35128, Padova, Italy

    Lino Polese

  3. Department of Medicine, 5th Medical Unit, University of Padova, Padua, Italy

    Silvano Fasolato & Paolo Angeli

  4. Department of Cardiology, Chest and Vascular Surgery, University of Padova, Padua, Italy

    Anna Chiara Frigo

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  1. Lino Polese
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  2. Carlotta La Raja
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  4. Anna Chiara Frigo
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  6. Stefano Merigliano
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Correspondence to Lino Polese.

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Polese, L., La Raja, C., Fasolato, S. et al. Endoscopic diode laser therapy for gastric hyperplastic polyps in cirrhotic patients. Lasers Med Sci 36, 975–979 (2021). https://doi.org/10.1007/s10103-020-03127-7

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  • DOI: https://doi.org/10.1007/s10103-020-03127-7

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