Pattern of Colorectal Polyps among Sudanese Patients: a Single Centre Experience

Abstract

Background: Polyps are masses projecting into the bowel lumen beyond the surface of the epithelium with or without a pedicle/stalk and it can be taken to mean a protuberant growth which can be either benign or malignant. The objective of the study was to study the pattern of colorectal polyps among Sudanese patients at Soba university hospital. Patients and methods: The study was a prospective, descriptive, cross sectional hospital based study. Conducted at Soba University Hospital department of endoscopy, in a period from Oct 2017 to August 2018.The study was conducted on Patients with colorectal polyps finding in colonoscopy or flexible Sigmoidoscopy. All the patients have been followed for duration not less than 3 months to assess the outcome. The main objective was to study the pattern of colorectal polyps among Sudanese population. Results: A total of (120) patients with colorectal polyps out of (626) patients underwent lower GI endoscopy during the period of the study, with male to female ratio of 1.8:1.0.The age ranged between (4) to (94) years. The incidence of polyp at the study was (19%). Thirty nine patient (32.5%) are smoker, while (6.7%) of the patients were alcohol consumers. NSAIDs consumptions were found in (40%) of the patients. Considering the consumption of fiber diet the study showed most of the patients were using the moderate fiber diet (53%). Schistosomasis found in 4 patients (3.3%) and these patients had polyps showing inflammatory polyps of schistosomasis origin. Presenting complains includes bleeding per rectum, altered bowel habit, mucus per rectum, abdominal pain, weight loss, abdominal distension, anorexia and anaemic symptoms. The most common co-morbidities were DM in (17.5%), IBD in (11.7%), FAP (6.7.4%) and diverticular diseases in (1.7%). The mode of the diagnosis was either through sigmoidoscopy or colonoscopy, and the NBI was used in (7.5%). The most common type was sessile polyps (67.5%) followed by pedunclated polyps (29.2%). Most of the polyps are within the left side, mainly at the rectum, anal canal and sigmoid colon. The size of the polyps lies between (1 mm to 50mm).The most common modes intervention was snare polypectomy (66.7%), followed by excision via biopsy forceps (62.7), while other treatment options are less frequent. Histopathology showed that most of the polyps were benign polyps (74.2%). (10.8%) were of high degree dysplasia and the rest was less frequent. Thirty three patients showed inflammatory polyps (27.5%) followed by tubulovilous adenomatous polyps (20.8% ), tubuloadenomatus polyp (11.7), juvenile polyp (10.8),hyperplastic polyps (9.2%), villous adenomatus polyp (5%), tubularadenomatus polyp (4.2%), schistosomal polyp (3.3%), hamratomatous polyp (2.5%) , fibroepithelial polyp (2.5%), invasive adenocarcinoma (1.7%) and granulomatus polyp (8%). Conclusion: The pattern of Colorectal polyps among Sudanese patients at our study was in line with international pattern in age, gender, common presentation, risk factors, types, shape and histopathology and most of them were of benign nature..