A polypectomy is a medical procedure used to remove a growth, known as a polyp, from the inner lining of a hollow organ. These abnormal tissue masses often develop in the colon, but they can also appear in areas such as the uterus, stomach, or nasal passages. The procedure is generally considered minimally invasive because it is most frequently performed during an endoscopic examination. Removing these growths plays a significant role in maintaining health and preventing the development of more serious conditions.
Why Polypectomy is Necessary
The main medical justification for performing a polypectomy is to prevent the progression of these growths into malignancies. While most polyps are initially benign, they can change over time through the adenoma-carcinoma sequence. This process describes how a non-cancerous polyp, specifically an adenoma, acquires genetic changes that transform it into cancer. Removing the polyp interrupts this biological process before malignant cells can form or spread.
Polypectomy is an integral part of colorectal cancer screening, as most polyps are found in the colon. Other reasons for removal include polyps causing symptoms like unexplained rectal bleeding, anemia from slow blood loss, or bowel obstruction. Once removed, the tissue is sent to a laboratory for analysis to confirm its nature and guide any necessary follow-up care.
The Polypectomy Procedure
A polypectomy is typically carried out during an endoscopic examination, such as a colonoscopy for growths in the large intestine. The endoscope is a long, flexible tube equipped with a light and a miniature camera, allowing the physician to visualize the organ’s lining on a screen. Specialized instruments are passed through a channel in the endoscope to perform the removal once a polyp is identified.
The technique used depends on the size and shape of the polyp. For very small polyps, often less than 5 millimeters in diameter, the physician may simply use biopsy forceps to grasp and snip the growth away. For larger polyps, a common method is the snare technique, where a thin wire loop is placed around the base of the polyp. An electrical current is then passed through the snare, which simultaneously cuts the polyp from the wall and cauterizes the tissue to control bleeding.
For particularly large or flat polyps, more advanced methods like Endoscopic Mucosal Resection (EMR) may be employed. EMR involves injecting a fluid, such as a saline solution, underneath the polyp to lift it away from the deeper muscle layer of the organ wall. This lifting action creates a protective cushion, making it safer and easier to remove the polyp, often in a single piece or in multiple fragments.
Recovery and Potential Complications
Recovery from a standard polypectomy is generally quick, with most patients returning to their usual activities the day after the procedure. Minor side effects are common immediately following the procedure, such as mild abdominal cramping or bloating caused by the air or gas used to inflate the organ during the examination. Patients may also notice a small amount of light rectal bleeding for a day or two after colon polyp removal.
The physician typically provides specific instructions regarding diet and activity for the first few days, often recommending avoidance of certain foods or liquids that could irritate the digestive system. Although polypectomy is well-tolerated, potential complications do exist, including bleeding that is heavier or more persistent than expected. Bleeding can occur immediately or be delayed for up to two weeks after the procedure.
A more serious, though rare, complication is perforation, which is a small tear or hole in the organ wall. Signs of a serious issue requiring immediate medical attention include severe abdominal pain that worsens over time, a fast heart rate, or passing a large amount of maroon-colored blood or clots. The risk of a perforation is very low, occurring in about one out of every 500 patients.