Prevalencia y características histológicas de los pólipos diminutos del recto y del sigmoides en una población colombiana

  • Julián Parga Universidad Nacional de Colombia
  • William Otero Regino Universidad Nacional de Colombia
  • Martín Alonso Gómez Zuleta Universidad Nacional de Colombia
Palabras clave: Pólipos diminutos, pólipos, adenomas

Resumen

Introducción: el cáncer de colon y recto (CCR) se origina a partir de pólipos adenomatosos y serrados. Por tanto, se recomienda que todos los pólipos colónicos sean resecados y enviados a patología. Sin embargo, en los pólipos diminutos (<5 mm) del recto y del sigmoides existe controversia sobre esta conducta, razón por la cual se ha planteado la estrategia de resecar y descartar o dejar in situ, a partir de la utilización de endoscopios avanzados (con una imagen de banda angosta [Narrow Band Imaging, NBI] u otras), y se logre concordancia con la histopatología, superior al 90 %. En nuestro medio, no hay estudios prospectivos con luz blanca sobre la prevalencia y las características histológicas de estos pólipos en el recto y el sigmoides. Por esta razón, se desarrolló este trabajo.

Materiales y métodos: estudio de prevalencia analítica, prospectivo. Se incluyeron las colonoscopias de tamización realizadas en la Unidad de Gastroenterología de la Clínica Fundadores de Bogotá, entre enero y julio de 2018.

Resultados: se incluyeron 719 pacientes. La prevalencia de pólipos diminutos en el recto y el sigmoides fue del 27 % (intervalo de confianza [IC], 95 %: 23,7-30,2 %). El 50 % eran pólipos adenomatosos, mientras que en 8 casos se presentó una displasia de alto grado (DAG). Entre los pólipos diminutos, 3 fueron tumores neuroendocrinos. No hubo cáncer en ninguna de las lesiones.

Conclusiones: la mitad de los pólipos diminutos encontrados fueron adenomatosos y 8 (0,83 %) tuvieron DAG. Recomendamos resecar todos los pólipos diminutos hasta que los estudios locales realizados con NBI u otra tecnología demostrasen la capacidad para discriminar en más del 90 % los pólipos hiperplásicos (dejarlos in situ) o adenomatosos (resecarlos).

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Biografía del autor/a

Julián Parga, Universidad Nacional de Colombia
Internista, Fellow de Gastroenterología, Universidad Nacional de Colombia, Hospital Universitario de Colombia
William Otero Regino, Universidad Nacional de Colombia
Profesor titular de Medicina, Unidad de Gastroenterología, Universidad Nacional de Colombia, Hospital Universitario Nacional de Colombia, Gastroenterólogo Clínica Fundadores
Martín Alonso Gómez Zuleta, Universidad Nacional de Colombia
Profesor asociado de Medicina, Unidad de Gastroenterología, Universidad Nacional de Colombia, Hospital Universitario Nacional de Colombia

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Prevalencia de pólipos por edad y género
Publicado
2020-03-27
Cómo citar
Parga, J., Otero Regino, W., & Gómez Zuleta, M. A. (2020). Prevalencia y características histológicas de los pólipos diminutos del recto y del sigmoides en una población colombiana. Revista Colombiana De Gastroenterología, 35(1), 25-32. https://doi.org/10.22516/25007440.363
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