Marian Bátovský
Endoscopic diathermocoagulation polypectomy is an excellent diagnostic method, and in justified cases also the definite treating method of polyps of the digestive tube some of which have a tendency to become malign. Particularly in the upper part of the gastrointestinal tract its diagnostic importance is applied since obtaining of the entire polyp (total biopsy) enables a thorough histological examination which is many times more precise than the forceps biopsy. The aim of this work is to help by interpretation of clinical, endoscopic and histological results of gastric polypectomy with accent on long-term follow-up of patients after this procedure. From diagnostic point of view every gastric polyp larger than 10 mm in diameter as well as every neoplastic polyp should be ectomized. Forceps biopsy is usually sufficient for diagnosis of fundic glands polyps, small hyperplastic polyps and NETs. All adenomas should be removed regardless of their size because of their malignant potential. The patients after polypectomy of fundic gland polyps and inflammatory fibroid polyps do not need the follow-up and gastroscopy after one year is sufficient. After endoscopic polypectomy of a hyperplastic polyp it is suitable to check the patient after 4 years and the first one should be performed in the first year after primary polypectomy. After polypectomy of adenomas the control should be done depending on the detected grade of dysplasia. After serious dysplasia or carcinoma in situ controls in 3-6 month intervals at least during first 2-3 years is recommended according to the degree of dysplasia. In other cases controls in the first year after polypectomy at least during first 2-3 years are adviced. The patients after polypectomy of small GIST should by controlled in one year intervals and after resection of NETs grade I and II in 6th, 12th and 36th month.