Clinical consequences of the endoscopic diagnosis of gastric polyps.

The procedure following endoscopic detection of a gastric polyp depends on the findings on histological examination of the lesion, for which forceps biopsy material usually suffices. If Elster's polyps are present, the recommendation is merely a search for epithelial tumors in the colorectum, which occur statistically more frequently in these patients. In the case of hyperplastic polyps, the recommended procedure is endoscopic polypectomy, typing of gastritis and regular follow-up examinations. Carcinoid tumors, which usually arise in type A gastritis, require only follow-up, while sporadic carcinoid tumors should be treated surgically. Irrespective of the type and grade of dysplasia, adenomas of the gastric mucosa should always be removed in toto. Polypoid type I or type IIa early carcinomas of the stomach initially only need to be removed endoscopically. If histological examination then reveals well or moderately differentiated adenocarcinoma limited to the mucosa, surgery is not necessary, but regular follow-up is essential.