Colon Polypectomy (Colon Polyp Removal)

En Espaol (Spanish Version)

Definition

This is the removal of one or more polyps from the inside lining of the colon (large intestine). A polyp is a mass of tissue that has the potential to develop into cancer. Most polyps can be removed during a colonoscopy or sigmoidoscopy.

A Colon Polyp

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Parts of the Body Involved

  • Colon
  • Rectum

Reasons for Procedure

The purpose of the surgery is to remove a polyp, a possible cancer source.

The greatest danger with intestinal polyps is their potential to turn into cancerous tumors. Regular screening to find polyps when they are small is important. In rare cases, larger polyps can cause troublesome symptoms, such as rectal bleeding, abdominal pain, and bowel irregularities. A physician will determine if your polyp is precancerous after it is removed and examined under the microscope.

Risk Factors for Complications During the Procedure

  • Type, size (larger than 20 mm), and location of the polyp
  • Patient factors such as blood-clotting disorders, substance abuse, or other diseases (obesity, diabetes)

What to Expect

Prior to Procedure

Your doctor will likely do the following, to determine if the polyps need to be removed:

  • Barium enema
  • X-rays
  • Diagnostic colonoscopy or sigmoidoscopyexamination of the inside of the intestine with an endoscope, a long, flexible instrument that shines light and allows the doctor to view the inside of the intestine through a tiny video camera

In the days leading up to your procedure:

Do not take aspirin or products containing aspirin, or anti-inflammatory drugs (such as ibuprofen) for one week before the procedure.Do not take any iron-containing supplements or medications for four days before the procedure.The rectum and colon must be completely clean for this procedure, therefore your doctor will prescribe a special cleaning solution and/or use laxatives and enemas for you to take 24-48 hours before the procedure.Arrange for a ride to and from the hospital.Do not eat or drink for at least eight hours before the procedure. During Procedure Sedative and painkillers will be given. You will be awake, but very drowsy. Anesthesia Sedative Description of the ProcedureYou lie on your side or on your back. A colonoscope, a soft, bendable tube approximately the thickness of the index finger, is inserted through the anus, and slowly pushed through the rectum to the colon. Various methods for removal are used depending on the size of the polyp. Using the colonoscope, the surgeon locates the polyp (or polyps), and snips them with a wire snare or cauterizes them with an electrical current. Bleeding during surgery is controlled by electrical current. The polyp or polyps are removed for lab testing. The colonoscope is slowly removed.
For larger polyps, a laparscopic surgical procedure may be considered. This is when small incisions are made in the abdomen and special instruments with a camera are used to perform the surgery After ProcedureThe polyps are sent to the laboratory for testing. You will wait until your doctor comes back to explain the findings. You may have some cramping or bloating until you pass gas. Your doctor will explain short-term dietary and activity limitations. How Long Will It Take? 30-60 minutes Will It Hurt? The special cleaning solution, laxatives, and/or enemas taken before your procedure often cause discomfort. During and following the procedure, there is little or no pain. However, discomfort in the form of pressure, bloating, and/or cramping often occurs due to air that enters the large intestine during the procedure. This discomfort usually subsides within 24 hours with the passage of gas. Your doctor may prescribe painkillers. If not, you can take non-prescription pain relievers for any residual pain. Possible Complications Complications are rare, but include: Opening in the colon wallExcessive bleedingAdverse reaction to the sedativeInfection at the site where the polyp or polyps are surgically removed Average Hospital Stay 0-1 day
Postoperative CareBecause the sedative will make you drowsy, don't drive, operate machinery, or make important decisions the day of the procedure.Return to your normal diet the same or next day. However, avoid tea, coffee, cola drinks, alcohol, and spicy foods (all of which can irritate the digestive system) for at least 2-3 days following surgery.To speed healing, resume normal activities as soon as you feel able (usually by the next day).Do not participate in any rigorous exercise for four weeks after the procedure (unless your doctor says otherwise).You will be scheduled for follow-up testing (colonoscopy) at least once per year, to check for recurrence of polyps. OutcomeYour doctor will discuss the results with you either the day of surgery or the following day. If cancer is detected, your doctor will explain your condition and treatment options. Additional treatment may include surgery, chemotherapy, and/or radiation therapy.Expect complete recovery from your polypectomy within two weeks. Call Your Doctor If Any of the Following OccursSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the rectum; up to cup per day of blood can be expected for up to 3-4 days following polypectomyCough, shortness of breath, chest pain, or severe nausea or vomitingConstipation or abdominal swellingNew, unexplained symptoms RESOURCES:
American Gastroenterological Associationhttp://www.gastro.org American Society for Gastrointestinal Endoscopyhttp://www.askasge.org CANADIAN RESOURCES: Canadian Association of Gastroenterologyhttp://www.cag-acg.org Canadian Institutes of Health Researchhttp://www.cihr-irsc.gc.ca References: American Gastroenterological Association website. Available at: http://www.gastro.org. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/. Colon polyps. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/colon-polyps/DS00511/DSECTION=1. Accessed May 6, 2008. Consolo P, Luigiano C, Strangio G, et al. Efficacy, risk factors, and complications of endoscopic polypectomy: ten-year experience at a single center. World Journal of Gastroenterology. 2008;14(15): 2354-2369. Available at: http://www.wjgnet.com/1007-9327/14/2364.pdf. Accessed May 6, 2008. Last reviewed May 2008 by Daus Mahnke, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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