Polypectomy

Posted on : July 26, 2022 by Clinic One Team on Digestive System

The development of an abnormal mass on the inner surface of a hollow organ namely the large intestine (colon) is known as a polyp.

These masses can be concerning as at times they can become cancerous or they can bring cancer with them, removal of such masses is done through a minimally invasive surgical procedure known as polypectomy, which is also known as colonic polypectomy.

The primary motive of polypectomy is to find out if the growth of the abnormal mass on the surface of the colon is cancerous, pre-cancerous, or non-cancerous.


Introduction

Polypectomy for colon polyps

Polypectomy is a surgical procedure that is used to extract polyps from the inner part of the large intestine, the product is qualified to be called a relatively non-invasive procedure, and it is usually done by sipping off a small polyp.

The procedure is generally done while performing a colonoscopy, at times it can be also done by performing open abdominal surgery.


How is Polypectomy Performed?

While performing a colonoscopy, a magnifying device which is a large flexible fiber optic endoscope known as a colonoscope is edged inside an individual’s rectum which helps a medical professional view all parts of his/her patient’s colon (large intestine).

A colonoscope consists of a camera and a light attached to the end of a flexible tube.

Medical professionals suggest that colonoscopy should be a routine checkup for individuals who are above 50 years of age to keep for growth of any mass that has a potential of developing into cancer or is indicated to be cancer.


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When is Polypectomy Performed?

While performing a colonoscopy if a health professional detects polyps then generally a polypectomy is performed at the same time and the mass of tissue is removed.

The removed tissue is sent for examination to check whether the mass that was found is cancerous, is developing to become cancerous, or is non-cancerous.

Most of the tumors that are found in the colon develop as non-cancerous masses before they become cancerous.

There is a ten percent chance for this abnormal mass to develop into cancer if the polyps are larger than twenty millimeters.

Usually, polyps do not show any symptoms but larger polyps might cause discomfort by showing symptoms stated below:

  • Rectal bleeding
  • Abdominal pain
  • Bowel irregularities

A polypectomy procedure is needed anytime when a polyp is found while a colonoscopy is performed. A polypectomy relieves a patient from all the symptoms that are being experienced by him/her.

The larger polyp cannot be removed through polypectomy, a surgery needs to be performed to remove the polyp.

A mass that is bigger in size that is if the polyp is more than one-third of the interior circumference of a colon then it cannot be removed through polypectomy, an open surgery or laparoscopic surgery needs to be performed for the removal of the mass.

The kind of method used to remove the polyp highly depends upon the kind of polyp that has developed, there are two kinds of ways in which polyp can develop.


1. Pedunculated polyp

Pedunculated polyp grows in a mushroom kind of manner, they have a long thin stalk that attaches it to the surface of the colon.
These kinds of polyps usually are not difficult to remove, they can be removed with a help of an electrical tool called a snare loop by a trained medical professional.


2. Sessile Polyp

Sessile polyps are flat or have a shape of a dome that develops on the surface of the colon.
These polyps, if they are small, are generally removed during a colonoscopy easily but the larger ones are difficult to terminate and require other forms of medical procedure to be extracted.


Who can Recommend Polypectomy?

Polypectomy  in Kathmandu

Polypectomy is often suggested by gastroenterologists.

Gastroenterologists are medical professionals who specialize in diagnosing and treating any health problems related to digestive systems.

Their area of expertise covers the whole digestive system including the esophagus, stomach, small intestine, large intestine, rectum, and anus, and also includes the pancreas, liver, bile ducts, and gallbladder.

They possess the special skills and techniques required to perform polypectomy.


Types of Procedure

A polyp can vary in size; it can be small, large, sessile, or pedunculated.

As mentioned above sessile polyps are flat and there is no stalk connecting them to the surface of the colon and pedunculated polyps have a stalk like a mushroom.

Techniques that a medical professional can use to remove polyps are:

  • Biopsy Forceps
  • Snare Polypectomy
  • Endoscopic Mucosal Resection
  • Endoscopic Submucosal Dissection
  • Open bowel surgery

For the removal of polyps that are less than five millimeters in diameter (small polyps), a medical professional can resort to biopsy forceps for the removal of the polyps.

Polyps that are anywhere between more than five millimeters to two centimeters in diameter are removed through a snare polypectomy.
A medical professional in this technique of polypectomy will loop a thin wire at the bottom of a polyp and with the help of heat, he/she will terminate the mass, after that if any tissue remains or the stalk of the polyp is removed with heat by cauterization.

A medical professional can use the Endoscopic mucosal resection (EMR) or Endoscopic submucosal dissection (ESD) technique to remove a polyp if the case is complicated or challenging because of the size of the polyp, location, or configuration, or if it has a high risk of complications.

In the endoscopic mucosal resection procedure using a fluid injection (generally the fluid injection that is used is made out of saline), the polyp is raised from the base tissue before the process of removing the polyp is performed.

A technique called piecemeal resection is used in which the polyp is extracted one piece at a time.
In the endoscopic submucosal dissection technique fluid is injected deep into the area where the mass has developed and the polyp is removed in a single piece.

In some cases, if the polyp is larger than normal the medium professional resorts to open bowel surgery for its removal.

The polyp after being removed is sent to a pathology lab to test for cancer. The results of the test usually come back in a week.


What to Expect at the Doctor’s Office?

polypectomy kathmandu

A polypectomy is a procedure carried out by a gastroenterologist with an anesthesiologist or nurse anesthetist assisting the gastroenterologist during the procedure.

After signing the documents consenting to the treatment an individual will be asked about his/her allergies before he/she is given any kind of anesthesia.

Medication will be given to the patient to relax his/her muscles, the medication can be edible or it can be given intravenously.

Then the individual will be placed on an examination table where the procedure will take place with his/her knees placed near his/her chest.

The medical professional will then edge a colonoscope from the individual’s rectum which will have a camera fixed on the end of a long flexible tube. To prevent pain an individual can also be given a local anesthetic.

If there is any sort of bleeding the medical professional will resort to giving his patient a suture to make the bleeding stop.

After the procedure is done, the medical professional will remove the colonoscope and the patient will be given some time to rest.

After the polyp has been removed successfully, it is sent for a test to examine if there is any evidence of colon cancer.



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Preparation for Polypectomy Treatment

Before going through the procedure a medical professional will instruct his/her patient to follow a set of guidelines, if an individual fails to do so he/she might be rescheduled to go through the procedure.


1. Drink enough liquids a day before the procedure

An individual is asked to drink enough liquids a day before the test but he/she is also asked to refrain from drinking colored liquid.


2. Laxative before the procedure

Before moving forward with the procedure an individual is asked to take a laxative few hours to clean the digestive tract so that the surface of the intestine is seen clearly, an individual can be given a laxative.


3. Not to eat before the procedure

A medical professional can ask his/her patients to skip breakfast on the day the procedure is to be performed.


4. Fast for twelve hours before the procedure

Some medical professionals can ask their patients to fast for at least twelve hours, meaning an individual is asked to not eat and avoid drinking anything to get an obstacle-free visual of the colon.


5. The anesthesiologist will ask the patient about his/her allergies

A medical professional will ask about his/her allergies before he/she is given any kind of anesthesia.


6. Inform the medical professional about the medication the patient is taking

A medical professional will ask his/her patient to disclose the medication that they take, important medication can be taken two hours prior to the test as per the doctor’s instructions.

At times certain kinds of mediation intervene with the procedure, hence an individual can be asked to not take them, and they can be asked to wait for hours before moving forward with the test.


Few materials will be required for comfort to prepare an individual for the treatment.


  1. Laxatives
    Laxatives can be suggested to be used by a medical professional, contact your medical professional regarding what laxatives he/she would suggest using.

  2. Diaper cream
    Pretreatment one is suggested to use diaper cream on their rectum.
    They are suggested to use diaper cream thoroughly to prevent any kind of skin irritation from diarrhea and constant cleaning of the rectum.

  3. Moist wipes
    Regular toilet paper might cause irritation if used too often hence it is suggested that an individual uses moist wipes.
    Preferably medicated moist wipes that contain ingredients like aloe or vitamin E.
    Products that contain these ingredients soothe irritated skin.

If an individual has any kind of doubt regarding these products they are suggested to contact their medical professional who will be treating them.


How Long does the Procedure take?

A polypectomy treatment is a short procedure, the duration of the treatment depends upon if there is any need for intervention.

Generally, a polypectomy treatment can take from twenty minutes to one hour.


How Long is the Recovery from a Polypectomy Treatment?

The road to recovery after the procedure is relatively short compared to other treatments.

After the procedure, a nurse will further explain what the patient might experience post-treatment.

Possible side effects that an individual might experience post-treatment other than some pain are bolting, cramps, rectal bleeding, and gas, these symptoms are generally mild and stop after twenty hours of the treatment.

It is also suggested that after going through with a polypectomy treatment an individual avoid driving or using heavy machinery for at least twenty-four hours as they might be experiencing some effects of the anesthetic that was given to them.

A common side effect that is felt by individuals after the treatment is their legs feeling unsteady and groggy.

Post-treatment a medical professional will ask his or her patient to avoid intake of certain food for two to three days to prevent their bowel system from getting irritated.

Food that one can be asked to defer are-

  • Tea
  • Coffee
  • Soda
  • Alcohol
  • Spicy food

Complete recovery can take twenty hours, and if the procedure is more intense then a full recovery can take two weeks. (Patients are also suggested to not smoke for two to three days.)


Risk of Polypectomy

A polypectomy treatment has the same risk as colonoscopy, it causes mild discomfort only.

Infection and perforation, or puncturing of the bowel, nerve damage near the area the polyp is located can be a risk factor of the treatment, these risks are very rare.

If an individual experiences fever or chills (symptoms of an infection), heavy bleeding (that is if the bleeding is more than just a teaspoon at a time), severe abdominal pain or bolting, vomiting, lightheadedness, dizziness, fainting, or irregular heartbeat; they are advised to contact a medical professional immediately.


Follow up

  • A polypectomy procedure generally does not require repetition of the treatment however it depends upon the test results that can back from the pathology lab about the polyp that has been extracted.

  • The medical professional will ask his patients to discuss the results regarding the polyp.

  • If the results of the polyp that has been removed come back as precancerous, or cancerous the medical professional will ask the patient to come back for other treatments.

  • If the results come back as non-cancerous then there will be no need for further treatment.

  • If the polyp has been tested to be precancerous there are chances that colon cancer can be prevented after the treatment and if the polyp has been found to be cancerous, the colon cancer can be treated with further medical treatment.

There are various factors that are taken into consideration for the success of the cancer treatment including what stage the colon cancer is at.


Conclusion

Polypectomy is a non-invasive treatment, it is done to remove abnormal growth of tissue which is known as a polyp.

It is done at the same time as a colonoscopy in exceptional cases if the polyp is large or complex then surgery will be required.

This treatment is done by a gastroenterologist with the presence of an anesthesiologist.

A polypectomy helps in determining if the abnormal mass that has been found is benign, precancerous, or cancerous, while most polyps are benign there are chances of the polyp turning precancerous, or cancerous.

The procedure is non-invasive but it has some mild side effects namely pain, cramping, gas, bloating, and rectal bleeding.


Where can I Book an Appointment?

You can book an appointment at Clinic One pretty easily by emailing us or calling us (given below) or simply coming in person to make an appointment, the choice is yours.

Our customer service department will choose a time at which both you and our doctor(s) are available.

Email[email protected]
Contact no: 9863393960 | 9801109235 | 015400400
or, Request an appointment below.


 

Reference 
https://www.karger.com/Article/FullText/495694
http://www.wjgnet.com/1007-9327/full/v22/i6/1925.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959925/
https://www.dovepress.com/advances-problems-and-complications-of-polypectomy-peer-reviewed-fulltext-article-CEG
https://www.virginiamason.org/complex-polypectomy-faqs
https://www.health.harvard.edu/womens-health/preparing_for_a_colonoscopy
https://www.childrenshospital.org/conditions-and-treatments/treatments/polypectomy-procedure/faq
https://www.winchesterhospital.org/health-library/article?id=14796
https://www.rdehospital.nhs.uk/docs/patients/bowel_cancer_screening/Colonoscopy.pdf 

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