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What is a polypectomy?

A polypectomy is the endoscopic procedure by which abnormal tissue is removed from the large intestine. The abnormal tissue growth can turn into colon cancer over time. Its removal prevents this and avoids the need for surgery.

Not all colonic polyps have this risk of malignant transformation, and the decision to remove them should be made with an endoscopist, sometimes after a histopathological result (microscopic examination of a polyp fragment obtained by biopsy during colonoscopy).

Most of the time, colonic polyps do not cause symptoms, so only sometimes, in the case of large polyps, their removal will also resolve symptoms such as bleeding in the stool, abdominal pain or intestinal transit disorders.

Possible complications of an endoscopic polypectomy are

Damage or perforation of the colon wall

Bleeding

Postpolypectomy coagulation syndrome

Adverse reactions to sedatives used

There are factors that increase the risk of complications:

Polyp type, size and location

Coagulation disorders, anticoagulant or antiplatelet treatments

Obesity or diabetes

Smoking

What to expect

Before the procedure the doctor:

  • He may give you a clinical examination;
  • He will ask you what your chronic medication is (anticoagulants such as acenocoumarol or antiplatelet agents such as aspirin or clopidogrel increase the risk of bleeding after polypectomy);
  • May require blood tests (blood count, coagulation tests, etc.).
  • The success of the polypectomy depends on the quality of the bowel preparation (its cleansing with the solutions recommended by the doctor, at the same time as the adequate water regime from the pre-exploration).
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Description of the procedure and its duration

A flexible tube with a chamber at the distal end is inserted through the anus to the end of the large intestine. During the examination the intestine will be relaxed with the help of the air blown through the endoscope. The doctor locates the polyp and removes it either by cold cutting or by using electricity (electroresection). The same current can be used to cauterize the remaining wound or to stop post-polypectomy bleeding. The resected polyp will be retrieved from the intestine and sent for complete microscopic analysis. If removal of the polyp is not possible endoscopically, it is advisable to mark its position for subsequent surgical removal (by minimally invasive, laparoscopic surgery).

The duration of the procedure is 30-60 minutes, as the case may be.

Is the procedure painful?

Polypectomy is no more painful than a diagnostic endoscopy. The discomfort is caused by the distension of the colon with air and the pressure that the device exerts on the walls of the intestine. Sometimes it is useful to use a superficial sedation to relieve discomfort.

When should you consult your doctor after the procedure?

  • Signs of infection such as fever and chills.
  • Black and soft stools like heavy fuel oil.
  • Pain or anal discharge (after the procedure we can expect the elimination of blood through the rectum, 1/2 cup a day for 3 days).
  • Coughing, shortness of breath, chest pain, severe nausea and vomiting.
  • Lack of intestinal transit for feces or gas.
  • Intense abdominal pain and hard abdomen, relaxed in volume.
  • New or unexplained symptoms.

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