0. Does a 4cm gastric polyp require immediate surgery?

Gastric polyps are a common type of polyp disease. There are many ways to treat them, generally medication and surgery are the main methods. Although surgery is effective in treating gastric polyps, it does have certain risks. Therefore, even if surgical treatment is considered, people will be wary of this. So, does a 0.4cm gastric polyp require immediate surgery? Let’s take a look below.

Whether to undergo surgery for a 0.4 polyp actually depends mainly on your own choice. Since the purpose of surgery is not necessary, general hospitals will give you two options, both of which are correct.

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1. Endoscopic treatment

Endoscopic resection is the preferred method for treating gastric polyps. The main methods include high-frequency electrocoagulation resection, laser and microwave ablation, nylon ligation and argon plasma coagulation.

(1) High-frequency electrocoagulation resection is the most widely used method at present. Its principle is to use the thermal effect generated by high-frequency current to cause tissue coagulation and necrosis to achieve the purpose of removing polyps.

(2) Microwave ablation uses the principle that microwaves can cause polar molecules to vibrate and produce thermal effects, thereby causing tissue coagulation and gasification to ablate the polyps. It also has a hemostatic effect and is suitable for sessile polyps with a diameter of less than 2 cm. Smaller polyps can be ablated in one go, while larger ones require multiple treatments.

(3) Laser method: The high-energy laser generated by the laser is used to irradiate the lesion site through the optical fiber introduced into the endoscopic biopsy hole. The heat energy converted from light energy causes the tissue protein to coagulate, denature and destroy, thereby achieving the treatment goal. It is mostly used to treat wide-pedunculated or sessile polyps.

(4) The nylon thread and rubber band ligation method ligates the root of the polyp, causing ischemia and necrosis, thus achieving the treatment goal. The polyp falls off and forms a shallow ulcer within the first week after ligation, and forms a white scar and heals within the 3rd to 4th week.

(5) Argon plasma coagulation Argon gas can conduct high-frequency electrical energy generated by tungsten electrodes through ionization, causing tissue coagulation. In recent years, it has been used in endoscopic treatment and has achieved good results. It is mainly suitable for broad-based, sessile polyps with a diameter of less than 1.5 cm.

(6) The freezing method involves spraying refrigerant gas directly onto the surface of the polyp through a special catheter and the endoscopic biopsy hole, or using a special freezing rod to perform contact freezing on the lesion, causing the tissue to necrotize and fall off.

(7) Radiofrequency method Radiofrequency is a type of electromagnetic wave with a frequency of 200 to 750 kHz. After entering the diseased tissue, it generates heat locally, causing the moisture to evaporate, dry out, and cause tissue necrosis to achieve the therapeutic purpose.

(8) Alcohol injection method: Anhydrous alcohol is injected around the base of the polyp under endoscopy. It is generally only used to treat broad-based polyps.

2. Anti-Hp treatment

Recent studies have shown that Helicobacter pylori (Hp) infection is closely related to the occurrence of hyperplastic polyps. After the successful removal of Hp infection in Hp-positive patients with hyperplastic polyps, about 40% of the patients have complete regression of polyps.

3. Surgery

Indications for surgery are:

(1) Sessile or sessile polyps larger than 2 cm.

(2) Polyps that progressively enlarge.

(3) Patients with pathological examination showing adenomatous polyps with dysplasia, suspected cancer, or cancer.