Otitis

Endoscopic rectal polypectomy. Endoscopic polypectomy of the intestines and stomach

Called abnormal benign formations, which are mounted on a wide base or have a leg. They can appear on any part of the body where there is a mucous membrane. The main method of treatment is polypectomy.

Concept of method

Polypectomy – surgical manipulation aimed at removing polyps.

The procedure is indicated for both single and multiple formations, the size of which does not exceed 5 mm.

It is believed that until they have reached these sizes, they are in the formation stage. Most often, the procedure involves trimming the stem using a wire loop through which a current is passed.

Indications

Polypectomy is performed for diagnostic and therapeutic purposes.

The first option is possible for any single formations, if technically possible. For polyposis histological examination several pieces are removed large sizes with a modified form.

Indications for treatment include any small polyps if surgery can be performed without the risk of complications.

If the formation appears on an internal organ, then the endoscopic method is used.

In situations where there are solitary formations or several located next to each other, surgery is indicated.

Contraindications

Elective removal is not carried out for patients who are in in serious condition or have problems related to blood clotting. To exclude contraindications, a blood test is required.

If the doctor decides that a polypectomy will lead to complications, the operation is also not performed.

Carrying out the procedure

There are several types of operations:

Excision. Applicable in modern clinics rarely, since there is still a risk of bleeding after it. Usually the method is relevant if histology is required.
Electroexcision. A lash is wound at the base and tightened until the formation changes color. After a few minutes, the coagulator is turned on. Thanks to this, the base of the polyp and the adjacent mucous membrane are completely eliminated. This is the main method.
Electrocoagulation. Used when the previous method is not possible. The method is used to eliminate bleeding. It is also used when loop electroexcision is incomplete.

Medical polypectomy. It is based on the introduction of alcohol into the base of the polyp, acetic acid and other aggressive environments.

Polypectomy of uterine polyp

It is important to perform surgery during hysteroscopy. Then the whole process takes place under supervision.

A device with a camera is inserted into the uterine cavity to determine the characteristics of the formation. Then it is unscrewed or cut out. The operation is performed under local anesthesia. All material is sent for histological examination.

Used and laser removal. Thanks to it, the risk of damage to healthy epithelium is eliminated. Manipulations are carried out at any age, regardless of type.

Cervical canal

Today, curettage is practically not prescribed, but if there is a suspicion of the malignant nature of the formation, then the doctor can refer for this procedure.

The endometrium is removed from cervical canal. The procedure is carried out at the end menstrual cycle, under anesthesia.

For this organ it is used:

Hysteroscope. The operation lasts several minutes and consists of removing only the polyp.
Laser. Reduces the risk of disease relapse and bleeding. The polyp disappears after cauterization using a laser beam.
Radio waves. There is no tissue injury during the operation. The procedure is considered the safest.

Stomach

With the endoscopic method, the mucous membrane is removed and treated with current. A scab forms at the cauterization site.

If the size of the formation is small, then the maximum possible area is rolled up with a loop. If the base is more than 1.5 cm, a series of surgical interventions is performed. The tumor is removed in parts. Between surgical interventions there are breaks of several weeks.

The operation is performed on a stationary basis. For convenience, the patient can be immersed in medicated sleep. Broadband operations for this disease are practically not performed today. Endoscopic instruments are inserted through small incisions in the skin.

Intestines

Often the formations are removed during a colonoscopy, diagnostic procedure.

Sometimes tumors that have begun to transform into malignant ones are removed in the same way.

IN modern medicine polypectomy is performed endoscopically. First, an endoscope is inserted into the intestine. Then a lead plate is attached to the lumbar region.

After fixing the endoscope, a loop is inserted into the canal, acting as a second electrode. The loop is placed over the polyp. As a result of exposure to current, the anomalous place is charred. The severed polyp is removed from the body.

Large formations can be removed by biting. This is done so that too large a burn does not lead to perforation and explosion of intestinal gases.

Gallbladder

Occurs using a diathermic loop. If the formation does not have a stalk, then it is removed in fragments. To prevent the vessels from bleeding, they are passed through a loop. This method allows you to save the organ.

However, this method is not in great demand, since the results and consequences have not been fully studied to this day.

Esophagus

Small polypectomy is performed endoscopically. The electrical loop is inserted under visual control. The latter provides the possibility of coagulation in all areas prone to bleeding.

Sometimes the pedicle is divided using scissors or a wire loop. The effectiveness of this method is inferior to the previous one, but there remains a risk of damage to the walls of the esophagus. Polypectomy is not performed to remove large lesions.

Nose

Polyps are removed using a loop or Lange hooks. They are inserted through the nostril under local anesthesia.

Gradually the lumen of the loop is narrowed and the polyp is cut off. The hook is used when it is necessary to remove a formation arising from the ethmoid labyrinth.

After the operation, the mucous membrane is disinfected. Turundas with Vaseline are inserted into the nose. After this operation, bleeding is insignificant.

Diet after polypectomy of the stomach and intestines

The speed of rehabilitation depends on adherence to the diet.

After the manipulation, the patient is not allowed to drink or eat for 24 hours. Then you are allowed to drink a little liquid, but not more than 50 ml. After 12 hours it is given congee or broth.

This is aimed at reducing intestinal activity and its excretory function.

After three days, the diet is supplemented with liquid porridge, meat soufflé. If after eating the patient notices increased gas production, the doctor changes the menu. It is allowed to eat oatmeal, risk, and millet.

The third stage of rehabilitation begins after 14 days. Over the next 4 months, it is recommended to adhere to fractional meals and a gentle diet. Fermentation processes in the intestines and constipation should not be allowed.

Remember that the fattier the food, the more bile is formed. You will also have to give up food that can injure the intestines. Sour, spicy and fried foods are prohibited.

Video shows endoscopic removal stomach polyp:

Endoscopic polypectomy is a very important surgical procedure. This is explained by the fact that the occurrence of neoplasms in the intestines is occurring more and more often in our time and the patient needs timely treatment.

Very often the disease occurs with erased clinical picture, significantly complicating its development. Surgery using colonoscopy effectively removes pathological growths.

Endoscopic polypectomy

Removal of a polyp during colonoscopy becomes a very useful consequence of such a diagnostic procedure.

It is performed under local anesthesia and performed endoscopically. The operation is minimally invasive, painless and harmless.

Endoscopic colon polypectomy is quite simple. It is performed in a sterile procedure room using special equipment. The patient lies on a special table, on his side, pressing his knees to his chest. The doctor administers anesthesia.

Then a flexible probe is inserted through the patient's anus. Inner surface the intestines are straightened with the help of air masses entering there.

Colonoscopy can detect polyps. The specialist examines them and applies adrenaline. The drug increases surface tone to improve resection. Afterwards, he uses special surgical equipment to excise the tumor and then cauterize the wound.

After the bleeding has completely stopped, the doctor performs a biopsy, sending samples to laboratory analysis.

What are polyps and the reasons for their formation in the intestines

The neoplasm is pathological growth mucous membrane of the organ.

Polyps are divided into a number of types that arise in the rectum or sigmoid colon:

The main reason for the appearance of polyps is hereditary predisposition To similar type neoplasms.

In second place in importance is unbalanced diet, hobby fatty foods, consumption various substances with signs of carcinogenicity or lack of vegetables and fruits.

To a large extent, chronic diseases provoke the development of polyposis. inflammatory diseases bowel dysfunction or dysfunction digestive system.

Smoking and alcohol abuse, obesity and physical inactivity play a significant role.

Endoscopic removal methods

This type of surgery aims to completely excise intestinal polyps. Benign tumors can be removed at the same time.

The operation is most often performed in a hospital. But polyps with a volume of less than half a centimeter can be removed in outpatient setting.

In the treatment of many diseases, the use of an endoscope is the method of choice. After applying local anesthesia, the patient does not experience any pain or discomfort.

There are three main types of laparoscopic surgery performed most often.

Main indications and contraindications for intestinal polypectomy

Most often, endoscopic intervention is recommended when the patient experiences foreign discharge from anus, which include inflammatory effusion, pus, blood, mucus.

Anemia of unknown etiology becomes the basis for colonoscopy.

For the purpose differential diagnosis it is carried out at various diseases Gastrointestinal tract.

There are a number of contraindications. Most often these include insufficient recovery after abdominal surgery, thrombopenia, infections, and fungal infection.

Endoscopic rectal polypectomy is not performed in case of exacerbation of pathologies of the reproductive and excretory sphere.

The procedure should be postponed if the patient is significantly weakened or during pregnancy.

Preparing for surgery: bowel cleansing, nutritional habits

To avoid complications, endoscopic polypectomy during colonoscopy must be carefully prepared.

First, you should completely cleanse your intestines.

For this purpose, a special slag-free diet is prescribed already two days in advance.
On the eve of the procedure, you need to drink castor oil.
Recommended to take pharmacological agent called Fortrans. One dose is diluted per liter of liquid and taken in a glass every twenty minutes.
A cleansing enema is performed. The first is done in the evening and three more in the morning.
You must come to your doctor's appointment on an empty stomach. You are allowed to drink a little weak tea or natural juice.

Progress of the procedure

Endoscopic polypectomy during colonoscopy is performed on an outpatient basis in a specially equipped room.

The patient is placed in the desired position, local anesthesia, and then a special device with a lighting fixture, a video camera and a surgical instrument attached to it is inserted into his anus.

Using a special apparatus, air is pumped into the intestinal cavity to straighten the organ and improve the specialist’s area of action.

He finds the polyp, treats it with adrenaline, and then excises it. After wound surface cauterized, and the colonoscope is removed from the intestine.

At the same time, the doctor removes part of the removed mucous membrane for further histological and cytological examination.

Recovery in the postoperative period, dietary features

After endoscopic polypectomy during colonoscopy, a full period of patient rehabilitation is required. It usually takes at least fifteen days.

Measures to restore the patient’s well-being are aimed at combating constipation, improving general condition, prevention of relapse of the disease. Must be applied special treatment nutrition, avoid physical and nervous overload.

A day after polypectomy, it is allowed to take a small amount of liquid by wetting the mouth with a solution of water with natural lemon juice. After three hours, the use of vegetable broth is allowed.

The next day, the patient is given a decoction of rice and fruit jelly. On the first day, food is taken only in liquid form to facilitate the functioning of the intestines. Dishes made from solid foods cannot be eaten.

After three days, you are allowed to switch to broths, purees or porridges, shredded chicken, baked, grated vegetables.

Every new product need to be agreed with a specialist. If there is the slightest discomfort or development of flatulence, it should be abandoned.

After fifteen days, cooking steamed dishes from finely chopped pieces is allowed for consumption.

It is required to use the principle of fractional nutrition.

Useful video

You can learn how to detect polyps and how to get rid of them from this video.

Possible complications and prognosis

The most common negative consequences of endoscopic polypectomy during colonoscopy include:

constipation;
infections;
bleeding;
stool disorders;
difficulties in retrieving instruments;
injuries internal cavity intestines.

If the diet is fully followed after removal of intestinal polyps by colonoscopy and the patient follows all other doctor’s recommendations, then the prognosis is usually quite favorable.

In those cases where he did not refuse bad habits, he has developed various complications or exacerbations of the underlying pathology, then it is necessary further treatment.

Price and reviews

Surgery is a fairly expensive procedure.

The total cost of a colonoscopy with polyp removal is the sum of the price of services medical institution and the complexity of the operation. Great value also has a specialist level of training.

The cost of the procedure starts from two thousand rubles. Increases its choice of a specific method of execution and drug for anesthesia.

Free polypectomy is performed in government institutions under the compulsory health insurance policy.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Previously, it was believed that removal of polyps in the intestine was advisable only for large or multiple neoplasms. However, the statistics on the degeneration of these benign tumors in malignant (10-30% of cases) showed specialists that to prevent cancer it is important to get rid of even small polyps.

Today, it is used to remove polyps in the large and small intestine. endoscopic treatment, except for cases where the neoplasm is located in parts of the intestine inaccessible to the endoscope. Large and multiple polyps with a high risk of degeneration into cancer are an indication for segmental resection surgery.

Treatment tactics

If a small polyp is detected, watchful waiting may be prescribed– the doctor monitors the dynamics of tumor growth throughout the year, and if there are no significant changes is not detected, surgery to remove polyps is not performed. However, in this case, it is imperative to continue to be examined regularly in order to eliminate the risk of degeneration in time.

Because of psychology Russian patients, in most cases, instead of wait-and-see tactics, endoscopic removal is immediately prescribed. People believe that there is no need to worry about small polyps and ignore doctors’ orders for repeated examinations, so specialists immediately take a radical approach to the problem - this is the safest option. Even a small tumor can quickly become malignant.

There is no conservative treatment for intestinal polyps - it is simply ineffective.

If there are others possible complications polyps - bleeding, persistent diarrhea, excessive mucus or severe inflammatory processes– wait-and-see tactics are not used, surgery is prescribed immediately.

Removal of polyps in the colon

In most cases, removal of polyps in the rectum with an uncomplicated course is carried out endoscopically during colonoscopy. The same treatment is used for polyps sigmoid colon. The operation is called polypectomy.

Preparing for surgery

In preparation for surgery, it is necessary to cleanse the intestines. To do this, the patient is advised to drink at least 3.5 liters the day before the procedure. clean water, food includes only liquid, light food. The evening before the procedure you should not eat or drink. A cleansing enema may be prescribed.

Sometimes a special solution with water and a laxative is prescribed. Most often this is a solution of polyethylene glycol (4 liters), which is drunk for 180 minutes the evening before surgery, or lactulose preparations (solutions of Duphalac or other medications containing this component). In the second case, 3 liters of liquid are divided into two doses - before lunch on the day before surgery and in the evening. After taking these solutions, you should experience diarrhea, possibly bloating and painful sensations in the stomach.

If the patient is taking blood thinning medications (Aspirin, Warfarin, Ibuprofen, etc.), it is important to inform the attending physician. Most likely, you will have to give them up 1-2 days before the colonoscopy.

Carrying out a polypectomy

colonoscopy

Colonoscopy is performed only in specially equipped rooms. The patient lies on the couch with his left side, and anesthetic drugs are administered. Polyps are accessed through anal hole, a flexible and thin endoscope (colonoscope) with a small flashlight and a video camera is inserted into it, which allows you to visually monitor the progress of the operation.

If the polyp is flat, a special drug (often adrenaline) is injected into it, which lifts it above the surface of the mucosa. The tumor is removed using an instrument with a diathermic loop at the end. They pick up the base of the polyp and cut it, while applying electric current to cauterize the damaged area and prevent bleeding.

Important! Excised polyps in mandatory sent for histological analysis, only after that it is diagnosed final diagnosis. If atypical cells are detected, indicating tumor malignancy, the patient is prescribed partial resection intestines.

IN in rare cases apply laser surgery for polyp removal. It is not as effective as colonoscopy, since it is not possible to obtain tissue material for histology (the polyp is simply burned to the root) and there are difficulties with visual control (due to smoke).

Transanal excision of polyps

If it is impossible to perform colonoscopic surgery, direct surgery through the anus. This treatment is not possible if the polyps are located further than 10 cm from the anus.

Before the operation local anesthesia according to Vishnevsky, general anesthesia is sometimes prescribed. A rectal speculum is inserted into the anus. The base/leg of the polyp is excised with special instruments (Billroth forceps), the wound is sutured with 2-3 catgut knots.

If the polyp is located in the interval of 6-10 cm from the hole, then during the operation, after inserting the rectal speculum, the sphincter is relaxed with the fingers, after which a large gynecological speculum is inserted, which is used to move the intestinal wall not affected by polyps to the side. Then a short mirror is inserted and the tumor is removed using the same procedure. Polyps are sent for histology.

Segmental resection of the large intestine

This operation is prescribed only when high risk malignancy of a colon tumor or the presence of multiple closely located polyps. Conducted under general anesthesia. Depending on the location of the tumors, the type of operation is chosen:

Anterior rectal resection. Prescribed for tumors above 12 cm from the anus. The doctor removes the affected parts of the sigmoid and rectum, and then sews the remaining parts of the intestine together. Nerve endings, healthy urination and sexual function are preserved, feces are kept normally in the intestines.
Low front. It is used when the tumor is located 6-12 cm from the anus. Part of the sigmoid colon and the entire rectum are removed, the anus is preserved. A temporary “reservoir” is created to hold the stool and a stoma (part of the intestine is drained out through the peritoneum) is created to prevent excrement from entering the healing sutured area of the intestine. After 2-3 months it is carried out reconstructive surgery on closure of the stoma and return normal function defecation.
Abdominal-anal. It is carried out when the tumors are located at a distance of 4-6 cm from the anus. Part of the sigmoid colon, the entire rectum, and possibly part of the anus are removed. A stoma is formed, which is closed after 2-3 months.
Abdominoperineal. Indicated when the tumor is located close to the anus. Part of the sigmoid colon, the entire rectum, anus and part of the muscles are removed pelvic floor. A permanent stoma is formed, since it is impossible to maintain the function of normal bowel movement (the sphincter is cut out).

Important! When a permanent stoma is opened, the patient is given recommendations on how to care for it and organize life activities. In most cases it is possible to achieve high quality life, despite the inconvenience and aesthetic defect.

Treatment of polyps in the small intestine

Single small polyps small intestine on the pedicle are removed using enterotomy; in the presence of other neoplasms, resection is indicated small intestine.

Performing an enterotomy

This surgery is dangerous and much more serious endoscopic methods and requires highly qualified surgeons. Stages of implementation:

The patient is placed under general anesthesia.
Over the required area A transverse incision is made into the small intestine with a scalpel or electric knife.
Polyps are excised through the incised area and sent for histology.
All incisions are sutured.

After the operation, the patient must remain in the hospital under the supervision of a surgeon and gastroenterologist. Bed rest is required, painkillers are prescribed to relieve pain, and a strict diet is followed. If the doctor is insufficiently professional, narrowing of the small intestine and bleeding may occur.

Segmental resection of the small intestine

The operation is performed open or laparoscopic method, the second is preferable because it has less negative consequences– the scars are smaller, the likelihood of infection is lower, the patient’s recovery is quick. Preparation for the intervention is carried out according to standard scheme described above. Execution proceeds as follows:

The operation lasts up to 3 hours, after which the patient is gradually removed from anesthesia (up to 2 hours). Recovery requires 3-7 days in hospital. When performing an open resection, one large incision is made in the peritoneum, rehabilitation requires up to 10 days in the hospital, otherwise there are no differences.

Rehabilitation period

Within 2 years after removal of polyps, the risk of relapse and bowel cancer is high. Patients are advised to undergo regular examinations - every 3-6 months. The first examination is scheduled 1-2 months after the operation. Subsequently (from the third year after treatment), examinations are required every 12 months.

Don't ignore preventive examinations, come to the doctor at the appointed time, follow his recommendations.
Give up bad habits; smoking and drinking alcohol are extremely undesirable.
You should not engage in heavy physical labor or lift weights - this will increase the risk of bleeding.
Avoid hypothermia and overheating, do not stay under sun rays, refuse the solarium and follow the prescribed hygiene measures.
Try to limit stress and prevent overwork. Healthy rest plays a significant role in recovery.

During the rehabilitation period it is necessary to follow a diet. During the first week after endoscopic surgery You should eat crushed food, purees, soft liquid porridges. Tough and difficult to digest foods rich in coarse fiber are excluded. Meals should be fractional - eat up to 6 times a day.

Important! After open operations The diet is prescribed by a doctor, it is very strict and excludes almost all food.

You will need to see a doctor immediately if you have the following complications:

Fever, chills;
Heaviness in the abdomen, nagging pain;
Redness, swelling in the anus;
Blackening of the stool, blood during bowel movements, constipation;
Nausea, vomiting and other signs of intoxication.

This may indicate dangerous consequences operations, which include bleeding, perforation of the intestinal wall, intestinal obstruction, enterocolitis, formation of fecal stones or malignancy.

Average prices

The cost of operations to remove polyps in the intestines varies greatly depending on the clinic, the qualifications of the doctor and the amount of work. The approximate price range is presented in the table.

Free treatment is possible in public clinics By compulsory medical insurance policy. Help under the VMP program is also possible if the malignancy of the polyp is confirmed.

Patient reviews often mention doubts about the need for surgery to remove polyps in the intestines. However, doctors unanimously argue that its implementation is justified, since it significantly reduces the risk of developing cancer. People who have undergone minimally invasive surgery are satisfied with the results and speed of rehabilitation. The main thing in treatment is to find an experienced and reliable doctor whose help you can rely on.

Video: endoscopic removal of intestinal polyps

Video: colon polyps in the program “About the Most Important Thing”

Colon polypectomy - removal of polyps from the inner lining of the colon. A colon polyp is a growth of tissue. Some types of polyps can develop into cancer. Most polyps can be removed during a colonoscopy or sigmoidoscopy.

Reasons for removing colon polyps

The purpose of the operation is to remove the polyp. This is done to prevent cancer.

In rare cases, large polyps can cause painful symptoms, such as rectal bleeding, abdominal pain and bowel disorders. Removing the polyp will relieve these symptoms.

How is colon polyps removed?

Preparation for the procedure Before the procedure, your doctor will likely prescribe the following:

physical examination;
review of medications taken;
checking stool for occult blood;
diagnostic colonoscopy or sigmoidoscopy - examination of the inside of the intestine using an endoscope.

The colon must be completely cleansed before the procedure. Any stool that remains in the bowel will block the viewing area. This preparation may begin several days before the procedure. Cleaning methods may include:

enema - liquid is injected into the rectum to stimulate bowel movements;
laxatives - medications that cause soft stools;
you need to take clear liquid food;
reception large quantity liquids to stimulate bowel movements.

In anticipation of the procedure:

The patient may be asked to stop taking certain medications a week before the procedure:

anti-inflammatory drugs (for example, aspirin);
blood thinners such as clopidogrel or warfarin;
supplements or vitamins containing iron;
You can eat a light meal the night before. You should not eat or drink after midnight before surgery;
If you have diabetes, you should consult your doctor if you need to take a dose of insulin;
You will need to arrange a trip home after the procedure.

Description of the procedure for removing colon polyps

The patient will be asked to lie on their side or back. An endoscope, which is a long flexible tube with a camera at the end, will be inserted through the anus. It will slowly push down the rectum and into the colon. Air is pumped through the device to open the colon.

Using a camera, the doctor finds the polyp. The polyp will be cut off special tool. In some cases, polyps can be destroyed using electric current. Electric current also used to close a wound and stop bleeding. The polyps are sent to the laboratory for examination. When the doctor has completed the operation, the instruments are slowly removed from the intestines.

How long will it take to remove colon polyps?

30-60 minutes.

Will it hurt?

Special cleaning solution, laxatives, and/or enemas often cause discomfort. There is usually no pain during or after the procedure. The patient may feel pressure, bloating, and/or cramping due to air being pumped into the colon. This discomfort will disappear once the gas is released. Your doctor may prescribe pain medication to relieve discomfort.

Caring for the patient after removal of colon polyps

Home care Full recovery usually takes about two weeks. To ensure normal recovery, be sure to follow your doctor's instructions, which may include:

You should not drive, operate machinery, or make important decisions on the day of the procedure until the sedative wears off.
You can return to normal food the next day. You should avoid drinking coffee, tea, carbonated drinks, alcohol and taking spicy food at least 2-3 days after surgery as this may cause irritation to the digestive system.
You can return to normal activities as soon as your condition improves. Most people feel quite well the next day.
You should ask your doctor about when it is safe to shower, swim, or expose the surgical site to water.
In the future, you should plan to have periodic colonoscopies. It is important to check for recurrence of polyps.
The doctor will discuss the results of the procedure on the day of surgery or the next day.

Contacting your doctor after colon polyp removal

Signs of infection, including fever and chills.
Redness, swelling, increased pain, bleeding or discharge from the rectum (up to 150 ml of blood per day can be expected for 3-4 days after polypectomy).
Black, tarry stool.
Severe abdominal pain.
Inability to pass gas or stool.
Cough, shortness of breath, chest pain, or severe nausea or vomiting.

Colon polypectomy – procedure complete removal polyps from the inner wall of the affected intestine. Colon polyps are benign neoplasms that can develop into malignant tissue (colorectal carcinoma). In the article we will examine the topic: colon polyps, stages, symptoms and manifestations, treatment and prevention of the disease.

Polyp

Attention! IN international classification diseases of the 10th revision, colon polyps are designated by code D12.

Symptoms and causes of polyps (briefly)

In most cases, intestinal tumors do not cause discomfort. Sometimes the polyp bleeds, which may show up as bright red blood in the stool. If blood stays longer in the intestines, it decomposes, leading to dark brown stools. Experts believe that only about five percent of all adenomatous polyps cause blood in the stool. In rare cases, a large polyp disrupts normal work digestive tract. Other growths can sometimes cause severe diarrhea.

Colon neoplasms are caused by increased growth of the intestinal mucosa. The reason may be the impact environment and overeating. Eating large amounts of animal fats and proteins increases the risk of developing tumors. They can also occur due to hereditary diseases. At hereditary diseases the risk of complications increases significantly.

Fatty foods

Indications and contraindications for surgery

Colonoscopy is necessary for diagnosis various diseases, early detection and colorectal cancer follow-up. Here are the most important indications to the use of colonoscopy:

A lot of blood in the stool;
Noticeable changes in bowel habits: diarrhea (diarrhea) or constipation;
Constant abdominal pain;
If the test is positive for occult blood in the stool (microhematuria), the test should be performed annually for screening colorectal cancer over 50 years of age;
For early detection of colon cancer, colonoscopy should be performed after 55 years every 2 years;
If you suspect hereditary diseases that can cause cancer or polyposis;
After removal benign neoplasms.

Removal of polyps in the colon

During endoscopic examination polyps of the ascending and other parts of the intestine are often removed immediately. This procedure, called a polypectomy, is used during colonoscopy.

Colonoscopy

Since colon cancer almost always develops from initially benign neoplasms, polyps in intestinal tract removed and examined histological methods. Hyperplastic neoplasms are the most common group (90% of all cases). In most cases, they do not degenerate into malignant cells.

Preparing for surgery

Before the operation begins, it is necessary to prepare and cleanse the intestines. To do this, an enema is done and a strong laxative is prescribed. Before the procedure, the intestines must be clean. A full intestine will interfere with the normal implementation of invasive intervention.

Important! Medicines that inhibit blood clotting (heparin, acetylsalicylic acid) are canceled 10 days before the start of the operation.

Carrying out a polypectomy

As mentioned above, polyps (tubular, tubular-villous, and villous) can be removed during a colonoscopy. Doctors call this procedure a polypectomy: an instrument with a thin loop is advanced into the intestinal cavity. This loop consists of a thin wire that is placed around the tumor and then tightened. Passed through a wire loop high frequency current– the polyp is cut off due to heat. At the same time, the heat seals the torn blood vessels epithelium. This is necessary to prevent bleeding. Smaller lesions (up to 5 mm) are usually removed using biopsy forceps.

The excised tumor is removed from the intestine along with an endoscope. It is sent to the laboratory for histological examination. In the laboratory, specialists will be able to determine the type of tumor and the presence of malignant cells.

Removing a polyp is not painful procedure. Before the procedure, the doctor takes a blood sample to check blood clotting values. During a colonoscopy, most patients take a tranquilizer, which puts them under anesthesia so they don't feel the uncomfortable feeling of pressure in their stomach.

Most polyps can be removed during a colonoscopy. If, however, the examination reveals a larger polyp that appears more difficult to remove, a second colonoscopy for polypectomy may be scheduled in these cases. In some situations, after such a complex polyp removal, the patient remains in the hospital for observation.

Transanal excision of polyps

If the distance from the polyps to the anus is no more than ten to twelve centimeters, they can be removed directly through the anus. By using special means Doctors widen the anus and cut out the polyp.

A special method is transanal endoscopic microsurgery (TEM), in which the polyp is removed microsurgically using a special endoscope.

Segmental resection of the large intestine

Some tumors cannot be removed with an endoscope alone. Especially wide tumors measuring two to three centimeters often cannot be completely removed from the intestine. If the number, size or type of intestinal polyps cannot be eliminated by an endoscope, surgical treatment is required.

Intestinal surgery is necessary if cancer cells of high oncogenic risk are found in the removed polyp. IN in this case there is a high risk of malignant tissue degeneration. Therefore, it is necessary to carry out resection (removal) of a certain part of the affected intestine in order to save the patient’s life.

Resection

If the procedure reveals less aggressive precancerous cells, surgery not required. However, regular colonoscopy is recommended to rule out the development of cancer.

Prevention and prognosis

Removal various types polyps is a standard and uncomplicated procedure. However, there is a risk of adverse effects. Main danger Colonoscopy – development of internal bleeding.

Under certain circumstances, the intestines or other abdominal organs may be injured by the endoscope. Anal surgery occasionally causes sphincter atony. In case of an operation through abdominal cavity Wound healing problems may occur internal organs or abdominal wall.

IN in some cases adhesions form, which cause complete obstruction of the intestine. Visible abdominal scars can cause not only anatomical disorders, but also functional ones. Damage nerve fibers leads to numbness, which usually disappears after a while. In some cases, bacterial and viral infections. Some patients developed internal bleeding which led to severe anemia.

If the procedure is performed on an outpatient basis, the patient should cleanse the intestines with an enema or laxative before the procedure. He is not allowed to drive or do other life-threatening activities after the minimally invasive procedure.

Laxative

Advice! For preventive purposes, it is necessary to conduct a colonoscopy regularly (every six months) to exclude the presence of cancer cells. You also need to change your diet by adding more fruits and vegetables to your diet.