Dr. Ertan Beyatlı

How are Colon Polyps removed?

(Update: ) - Digestive System Diseases

In this article, I will give information about the follow-up and treatment of colon polyps, which are frequently encountered in the world and especially in our country.

Commonly used Polyp the word is in Latin Polyp comes from the word. Pathological formations originating from the walls of organs covered by mucosa in the body (such as stomach, small intestine, colon, bladder, uterus, etc.) are called polyps. These formations among the right are sometimes "meat me"Is called.

There are many different types of polyps. There are pedunculated polyps, broad-based polyps, cluster-like polyps, nodular polyps.

Polyps are generally benign formations but when seen must be removed ve follow-up It should be.

Large Intestine (colon) Polybi

It is seen in every part of the large intestine extending from the anus region (anal canal) to the small intestine (ileocecal region). the most common disease is a polyp. 60-70% of polyps left colon seen on the side.

Colon polyps
Colon polyps are most common on the left side.

What are the Causes of Colon Polyps?

The causes of most polyps are unknown (idopathic). Some polyps show a hereditary predisposition. Some of the polyps also constitute the first stages of some malignant bowel cancers. pre-cancerous called polyps.


What are the Symptoms of Colon Polyps?

Most colon polyps symptomless and silent continues to grow insidiously. Symptoms that will occur with colon polyps include:

  • Change in bowel habits (Constipation or diarrhea)
  • Invisible blood in the stool (occult blood in stool GGK)
  • Rectal bleeding (Melana, hematochezia, rectoraji) the color of the stool is sometimes black and sometimes black (melana)
  • Abdominal pain, Nausea
  • Rectal itching (pruritus sudden)
  • Weakness, headache, tiredness, shortness of breath
  • Pale skin color
  • Iron deficiency anemia

What are the types of colon polyps?

Not all colon polyps are the same. There are different histological types, that is, the cells that make up the polyp have different characteristics when viewed under a microscope. It also varies by size, number and location. Most importantly, they vary in their tendency to become cancerous (malignant).

Adenomatous polyps

The most common type of polyp is adenoma or adenomatous polyp. Not only because it is the most common but also Colon cancerIt is an important type of polyp as it is the most common cause of the disease. The likelihood that an adenoma will turn into cancer (or develop before) depends in part on its size; The larger the polyp, the greater the likelihood of the polyp becoming malignant or worsening (with a large polyp larger than one centimeter in size, concern about malignant potential increases). It is also important whether there is a single polyp or multiple polyps. Patients with multiple polyps - even if they are not malignant when examined under a microscope - are more likely to develop additional polyps that may be malignant in the future. Anxiety about this increased malignant potential begins when there are three or more polyps. Finally, the malignant potential of an adenomatous polyp relates to the way the polyp cells organize themselves as seen under the microscope. Self-tubular structures (tubular adenomas) the cells that organize themselves into finger-like structures (villous adenomas), it is less likely to be cancerous than cells that organize into it.

Most adenomatous polyps are considered sporadic, meaning they are not caused by a recognized genetic mutation at birth (non-familial). However, its occurrence twice as often in first-degree relatives raises the possibility of a genetic factor that works even in sporadic adenomatous polyps.

Genetic adenomatous polyp syndromes (FAP)

There are many families, genetic conditions in which mutations are programmed into the individual's genes, which are passed down from parents to the child before birth. In the most common of these conditions, hundreds of thousands of adenomatous polyps form as a result of a mutation in the APC gene (familial adenomatous polyposis or FAP = familial adenomatous polyposis). Because of these polyp syndromes and the malignant potential of these polyps is much greater than that of individuals without the genetic abnormality, it is important to recognize the exact genetic abnormalities that cause them, if possible. (80% or more of these patients may develop colon cancer). While these syndromes are only responsible for one percent of all colon cancers, recognition of a polyposis syndrome identifies patients that require more frequent screening for additional polyp. Hereby, new polyps and cancers can be discovered and treated early. It may even be recommended to remove the entire colon to prevent cancer (Total Colectomy). In addition, genetic tests can be performed to determine whether the relatives of the patients' relatives have the same mutation as the patient, and therefore the possibility of developing polyps and cancer is very high. Relatives with the same mutation can then be screened for the presence of polyps and cancer, preferably beginning at an earlier age than is normally done because cancers in these syndromes develop at an earlier age than cancers not associated with a syndrome. Because of the gene's autosomal dominant mode of inheritance and effects, only one parent's FAP gene needs to be passed on to their offspring, and therefore each one's child has a 50/50 chance of developing FAP.

There is a rare form of FAP in which the number of polyps is less than attenuated FAP than classical FAP (less than 100). Attenuated FAPThe APC gene mutation in is different from the mutation in classical FAP. Patients with multiple polyps but lacking numbers seen in FAP should be identified and tested for mutation. Unlike classical FAP, which is an autosomal dominant syndrome, this rarely occurs because attenuated FAP must inherit a mutated gene from each parent to develop a polyp and colon cancer, and the mutation is rare.

Another syndrome of polyps and colon cancer is MYH polyposis syndrome (MUTYH). Individuals with MYH polyposis develop less than 100 polyps at a young age and are at high risk for developing colon cancer. Mutations in a gene other than FH, MYH gene; however, the mutation occurs sporadically due to spontaneous mutations and thus, although it can be seen in siblings, no inherited pattern appears in the parents. MYH polyposis syndrome is rare, as it is an autosomal recessive gene that requires a mutated gene from each parent.

Hyperplastic polyps

The second most common type of colon polyp is hyperplastic polyp. It is important to recognize these polyps and to distinguish them from adenomatous polyps because they do not have the potential to become cancerous unless they are located in the proximal (ascending colon) or show a specific histological pattern under the microscope. However, there are rare genetic syndromes in which patients form many hyperplastic polyps. These patients may be at a similar risk of developing colon cancer as patients with multiple adenomatous polyps, especially if the polyps are large, jagged, located in the ascending colon, and if there is a family history of colon cancer. Hyperplastic polyps can coexist with adenomatous polyps.

Other types of colon polyps

There are much less common colon polyps and their potential to become cancerous varies greatly, such as hamartomatous, juvenile, and inflammatory polyps.

Is the size of colon polyps correlated with cancer risk?

Colon polyps can range in size from a few millimeters to several centimeters. The larger the polyp, the more likely it is to have cancer within the polyp or that the polyp will later become cancerous.

Diagnostic Methods

How to Understand Colon Polyps?

Since most polyps do not cause symptoms arise by chance. Some tests can be used at the diagnosis stage:

At the diagnosis stage the most important factor is to distinguish between benign and malignant polyps. Therefore, which appeared by chance all of the polyps (total excision-polypectomy) or a portion of it (excisional biopsy) taken to pathological examination must be sent.

Colonoscopic Polypectomy

Polyp removal by endoscopy

Colonoscopic Polypectomy

Colonoscopy method in Colon Polyps It is the most accurate method of diagnosis. Polyps detected during colonoscopy are covered with a special wire (polypectomy snare) and burning tool (cautery) and removed with a basket. The name of this process Polypectomydir. After polypectomy, it is necessary to follow up the patient and repeat the colonoscopy procedure after a certain period (2-6 months) It is very important.

In the video below, we detected a polyp incidentally during the colonoscopy procedure in one of my patient and performed a polypectomy.

Do Colon Polyps Recur?

I can say that this is the most frequently asked question 🙂 Polyps that are totally removed do not repeat, but there is the possibility of new polyps forming in other parts of the colon.

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