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NEWS & VIEWS
CLINICAL GUIDELINES
Consensus for the management of patients with gastric polyps
Paul J. Kelly and Gregory Y. Lauwers
Gastric polyps are a heterogeneous group of lesions that have differing consequences for patients, particularly in terms of malignant potential. However, there is currently no consensus for the management of patients with these polyps. The British Society of Gastroenterology has, therefore, published objective management guidelines for patients with these lesions.
Kelly, P. J. & Lauwers, G. Y. Nat. Rev. Gastroenterol. Hepatol. 8, 78 (2011); published online 30 November 2010; http://www.nature.com/doifinder/10.1038/nrgastro.2010.187
Web End =doi:10.1038/nrgastro.2010.187
A gastric polyp is any lesion that protrudes into the lumen of the stomach. In this context, gastric polyps comprise a heterogeneous group of lesions that can derive from epithelial or nonepithelial tissue. With expanding indica tions for esophago
gastroduodenoscopy, polyps are being encountered with increasing frequency and are currently identified during ~5% of upper gastrointestinal tract endoscopies, mainly as incidental findings.1 Importantly, many gastric polyps have signifi cance for the patient in terms of their malignant potential or as a result of associations with inheritable syndromes.
The British Society of Gastroenterology (BSG) has published succinct, evidencebased guidelines for the management of patients with gastric polyps to address the lack of consensus for this population of patients.2 The guidelines were formulated following evaluation of many studies by the authors, and incorporate the opinions of the 274 members of the gastro duodenal section of the BSG. The guidelines discuss the classifica tion of the main types of gastric polyps and provide management recommenda tions for these polyps. The management of patients with early gastric cancer, which accounts for just under 2% of gastric polyps,3 is not included. The management of patients with gastro intestinal stromal tumors and gastric neuro endocrine tumors (socalled carcinoid tumors) is only briefly reviewed, as guidelines for the manage ment of patients with these tumors have been published separately.4,5 The guidelines are summarized in two tables with a useful algorithm as an aide memoire.
One of the main recommendations is that, at the very least, a biopsy sample should be
obtained from all gastric polyps detected at endoscopy. This recommendation is not surprising, as histo pathological assessment is required to establish the diagnosis and assess for the...