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  • Colon Polypectomy

    (Colon Polyp Removal)

    Definition

    A colon polypectomy is the removal of polyps from the inside lining of the colon, also called the large intestine. A polyp is a mass of tissue. Some types of polyps can develop into cancer. Most polyps can be removed during a colonoscopy or sigmoidoscopy .
    A Colon Polyp
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    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    The purpose of the surgery is to remove a polyp. It is done to prevent cancer .
    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:
    • Smoking
    • Type, size, and location of the polyp
    • Patient factors, such as blood-clotting disorders, substance abuse, or other diseases like obesity and diabetes

    What to Expect

    Prior to Procedure

    Your doctor will likely do the following:
    • Physical exam and health history
    • Review of medicines
    • Your bodily fluids may need to be tested. This can be done with blood tests.
    • Pictures of your colon may need to be taken. This can be done with X-raysor a Barium enema .
    • An examination of your intestine may need to be done. This can be done with a diagnostic colonoscopy or sigmoidoscopy.
    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 like 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. 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.
    • Resume normal activities as soon as you feel able. Most people feel well enough by the next day.
    • Ask your doctor when you can exercise.
    • Ask your doctor about when it is safe to shower, bathe, or soak in water.
    • You will be scheduled for a follow-up colonoscopy in the future. It will be important to check for 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 per day of blood can be expected for up to 3-4 days following 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
    In case of an emergency, call for medical help right away.

    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

    Colon polypectomy (polyp removal). Dartmouth-Hitchcock website. Available at: http://patients.dartmouth-hitchcock.org/gi/colon%5Fpolypectomy.html. Accessed February 6, 2013.

    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.

    How is colorectal cancer treated? The American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F8%5FMaking%5FTreatment%5FDecisions%5FColon%5Fand%5FRectum%5FCancer.asp?sitearea= . Updated January 17, 2013. Accessed February 6, 2013.

    Surgery for colorectal cancer. The American Cancer Society website. Available at: http://www.cancer.org/cancer/colonandrectumcancer/overviewguide/colorectal-cancer-overview-treating-surgery . Updated January 17, 2013. Accessed February 6, 2013.

    Understanding polyps and their treatment. American Society for Gastrointestinal Endoscopy website. Available at: http://www.askasge.org/patients/patients.aspx?id=396. Accessed February 6, 2013.

    6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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