Colon Polypectomy
(Colon Polyp Removal)
Definition
A colon polypectomy is the removal of polyps from the inside lining of the colon (large intestine). A polyp is a mass of tissue. Some types of polyps have the potential to develop into cancer. Most polyps can be removed during a colonoscopy or sigmoidoscopy .
A Colon Polyp
Reasons for Procedure
The purpose of the surgery is to remove a polyp. It is done for cancer prevention.
In rare cases, larger polyps can cause troublesome symptoms, such as rectal bleeding, abdominal pain, and bowel irregularities. A polyp removal will relieve these symptoms.
Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have a polypectomy, your doctor will review a list of possible complications, which may include:
- Damage to the colon wall
- Bleeding
- Infection
- Adverse reaction to the sedative
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam and health history
- Review of medicines
- Test your stool for hidden blood (called "occult blood")
- X-rays — an exam that uses small amounts of radiation to make a picture of the inside of the body
- Barium enema —x-ray exam that uses contrast to help better see the colon
- Diagnostic colonoscopy or sigmoidoscopy—examination of the inside of the intestine with an endoscope
Your colon must be completely cleaned before the procedure. Any stool left in the intestine will block the view. This preparation may start several days before the procedure. Follow your doctor's instructions, which may include any of the following cleansing methods:
- Enemas —fluid introduced into the rectum to stimulate a bowel movement
- Laxatives—medicines that cause you to have soft bowel movements
- A clear-liquid diet
- Oral cathartic medicines—a large container of fluid to drink, which stimulates a bowel movement
Leading up to your procedure:
-
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
- Iron supplements or vitamins containing iron.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- Wear comfortable clothing.
- If you have diabetes, ask your doctor if you need to adjust your insulin dose.
- Arrange for a ride home after the procedure.
Anesthesia
You will receive a sedative. This will help you relax. You will be drowsy but awake.
Description of the Procedure
You will be asked to lie on your side or on your back. A scope, a long flexible tube with a camera on the end, will be inserted through the anus. It will be slowly pushed through the rectum to the colon. The scope will also add air to open the colon.
Using the scope, the doctor will locate the polyp. The polyp will be snipped off with a wire snare from the scope. In some cases, the polyp may be destroyed with an electric current. The electric current is also used to close the wound and stop bleeding. The polyps will then be removed for lab testing. When the doctor is finished, the scope will be slowly removed.
For larger polyps, a laparoscopic surgical procedure may be needed. Special surgical tools will be inserted through small incisions in the abdomen. The tools will be used to locate and remove the polyp.
How Long Will It Take?
30-60 minutes
Will It Hurt?
The special cleaning solution, laxatives, and/or enemas often cause discomfort. During and following the procedure, there is little or no pain. You may feel pressure, bloating, and/or cramping because of the air passed into the colon. This discomfort will go away with the passing of gas. Your doctor may prescribe pain medicine. If not, you can take non-prescription pain relievers for discomfort.
Post-procedure Care
At the Care Center
The polyps will be sent to a lab for testing.
At Home
Expect a complete recovery within two weeks. To ensure a smooth recovery, be sure to follow your doctor's instructions, which may include:
- The sedative will make you drowsy. Do not drive, operate machinery, or make important decisions the day of the procedure.
- Return to your normal diet the same or next day. Avoid tea, coffee, cola drinks, alcohol, and spicy foods for at least 2-3 days following surgery. These can irritate the digestive system.
- To speed healing, resume normal activities as soon as you feel able. Most people feel well enough by the next day.
- Ask your doctor when you can participate in any rigorous exercise.
- You will be scheduled for a follow-up colonoscopy in the future. It will be important to check for recurrence of polyps.
Your doctor will discuss the results with you either the day of surgery or the following day.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the rectum (Up to ½ cup of blood per day can be expected for up to 3-4 days following your polypectomy.)
- Black, tarry stools
- Severe abdominal pain
- Hard, swollen abdomen
- Inability to pass gas or stool
- Cough , shortness of breath, chest pain, or severe nausea or vomiting
- New, unexplained symptoms
RESOURCES:
American Gastroenterological Association
http://www.gastro.org/
American Society for Gastrointestinal Endoscopy
http://www.askasge.org/
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
http://www.cag-acg.org/
Canadian Institutes of Health Research
http://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 J Gastroenterol. 2008;14(15): 2354-2369. Available at: http://www.wjgnet.com/1007-9327/14/2364.pdf. Accessed May 6, 2008.
Last reviewed November 2009 by Daus Mahnke, MD
Please 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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