What are colon polyps?
Colon polyps are protruding sections of the mucous lining the lower digestive system. Generally they measure from a few millimeters to a few centimeters in length and vary in shape, from barely prominent or flat to having a stalk that joins the mucosa (mushroom shaped) referred to as pediculated. Polyps have a distinctive cellular makeup that is prone to precancerous changes. These are called adenomatous polyps. These polyps can degenerate over time, developing a cancerous lesion. It is important to remove them while they are still small in order to prevent its progression. For this reason we must consider polyps to be precancerous lesions.
How are polyps treated?
The majority of polyps can be removed directly at the time of the endoscopy, a process known as endoscopic polypectomy. Most of the time this is performed as an outpatient procedure, under sedation, without the need for admission to the hospital and without general anesthesia. Few cases, depending on the size of the polyps and the condition of the patient, will require hospital admission.
The extracted polyps during the procedure must undergo microscopic analysis to study their characteristics and determine if there is any degree of malignancy.
Polyp is identified.
It is captured with a polypectomy loop.
Heat is applied with the loop.
Polypectomy is achieved with no complications.
How long does the polypectomy take to perform?
The average time of the procedure is 15 minutes. This can vary depending on the size and location of the polyp.
Endoscopic polypectomy with hot loop.
What preparations are needed to undergo a polypectomy?
This will depend on the location of the polyp within the digestive system. If they are required in the esophagus, stomach, or duodenum, a minimum of 8 hours of fasting is required.
If it is located in the colon, a special colonic preparation is required, which includes liquid diet on the day prior to the study, and the use of prescribed laxatives according to the age and general condition of the patient.
The patient undergoing an endoscopic polypectomy must keep relative rest for a week, avoiding the following: physical exertion, walking long distances, running, or weight training. A special diet must be followed, making sure to eat slowly. The patient can normally return to regular working activities the day after the procedure.
Patients that have 4 to 10 polyps extracted require follow up endoscopic studies 6 months and one year later, depending on the size and type of polyp extracted. It is important to comply with the follow up as some lesions may reappear over time.
What are the complications of a polypectomy?
The two major complications are hemorrhage and perforation, although the incidence is very low, at 0.2% and 3% respectively. Both risks can be avoided by having the proper endoscopic equipment, add-ons, and experience of advanced endoscopic procedures.
In the Center for Advanced Endoscopy we have the expertise and proper advanced equipment necessary to perform advanced endoscopic procedures at the highest level.