What happens when polyps are removed from colon

If you’re at average risk for colon cancer, you should undergo a colonoscopy every 10 years, starting at age 45. If you’re at increased or high risk for colon cancer due to family or personal history, you must have a colonoscopy more frequently.

When your doctor inserts the colonoscope into your rectum and threads it through to your colon, they’re looking for abnormalities that could be a sign of colon cancer or a precursor to colon cancer. One type of common abnormality is called a polyp.

A colon polyp is a clump of abnormal cells that grows in the lining of your colon. Some polyps are pedunculated, which means they’re attached to a stalk. At Colon and Rectal Surgeons of Greater Hartford, when our colorectal experts spot a polyp during your colonoscopy, they remove it.

Because most polyps are benign and never become cancerous, you may wonder if they’re even worth the bother of removing. Can’t you just leave them in place? Following are some reasons why you shouldn’t.

Polyps can mutate to cancer

The primary reason for removing any and all polyps detected during your colonoscopy is that a small percentage could mutate and become cancerous. Colon cancer kills about 50,000 people in the United States each year.

Even though only 15% of polyps detected during colonoscopy are villous or tubulovillous adenomas, which have a high risk of becoming cancerous, removing them completely eliminates that risk. Considering the stakes, then, there’s no justification for leaving a polyp in place.

In fact, one of the main reasons to have a colonoscopy is to remove polyps. Polyps are, by their nature, extremely proliferative cells, which means they grow at an abnormally fast rate and create many copies of themselves, just like cancer does. The more they mutate over time, the more likely it is that a mutation will eventually lead to cancer.

Colon cancer is a slow-growing cancer. That means it could take up to 10 years for a “benign” polyp to turn cancerous. By the time a polyp’s become cancerous, it may be too late to treat your disease, or your treatment could require extensive surgery.

Even “benign” polyps cause trouble

Noncancerous polyps aren’t as trouble-free as their “benign” label suggests. They’re abnormal growths that obstruct the passage of feces and could cause symptoms such as:

• Bleeding from rectum
• Black or tarry stool
• Chronic constipation or diarrhea
• Pain
• Anemia

Benign polyps are still abnormalities, even if they never become cancerous. They bring no benefits but raise your risk for colon cancer in the future.

We remove your polyps

During your colonoscopy, when we identify a polyp, we can usually remove it with small tools that go through the same tube as the miniature camera. Almost all polyps can be removed during the colonoscopy, with no need for an extra procedure.

Any polyp we remove is sent to a laboratory to see if it’s potentially cancerous. If your polyps are extra large or have signs of cancer, we may need to perform a separate procedure. 

Regular colonoscopies with polyp removal decrease your risk for colon cancer. They also improve your chances of remission and survival if we do detect cancer; colon cancer in its early stages is highly treatable. 

Remove troublesome colon polyps by booking a colonoscopy today. Call our team at 860-242-8591, or schedule an appointment online.

The presence of polyps — abnormal, precancerous growths in the colon — doesn’t necessarily mean you have cancer. But if they’re not removed, that risk exists.

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So when it comes to removing complex colon polyps, patients and their doctors must make a choice: polyp extraction via colonoscopy or invasive surgery.

“The discussion should revolve around the risks and benefits of both options,” says Anoop Prabhu, M.D., a clinical lecturer in gastroenterology at Michigan Medicine. “There are issues associated with each option.”

Both methods bear similar recurrence rates, he notes, meaning other factors influence the decision.

A larger or hard-to-reach polyp might prompt a clinician to advise surgery for patient safety and the best results. Patient preference or absence of a local doctor trained in polyp removal via colonoscopy also may influence the treatment decision.

In less severe circumstances, the endoscopic route — also known as a polypectomy — could work to reduce medical costs and recovery time, among other things.

One variable that ends the debate: if a biopsy confirms the polyp is cancerous.

“Once cancerous tissue is identified, the conversation is completely different,” Prabhu says. “Surgery is still considered the standard of care.”

Prabhu, also director of endoscopy for the VA Ann Arbor Healthcare System, shared information that all parties should consider before making a verdict:

Differing methods

Polypectomy can be done via a colonoscope (a thin, flexible tube) by injecting fluid under the polyp to raise it, after which it is removed with a snare. A heat current in the snare cauterizes tissue at the cut to avoid bleeding. With the aid of a sedative, discomfort is minimal for polypectomy recipients.

Surgery, on the other hand, involves small incisions in the abdomen to laparoscopically insert small tools and a camera into the abdomen — which is expanded with carbon dioxide. In some cases, an open surgery is required, necessitating a larger incision into the abdominal wall.

Unlike a polypectomy, part of the colon is removed to ensure all of the polyp and any related cancer is gone. All patients are under general anesthesia for the surgery, which can last a few hours.

Potential complications

Tools used during the endoscopic method present minimal risk of perforations or bleeding. In experienced hands, these complications occurred in only 1 percent of patients, according to a 2015 study published in Gut, an international gastroenterology journal.

SEE ALSO: A Colon Polyp Primer: Know the Types and Your Risk Factors

Surgery also has dangers. In addition to infection at the surgery site or incision, a patient could develop an anastomotic leak, a serious complication caused by sutures failing to hold the incision together. A 2013 study in Digestive Surgery found postoperative complications in one-third of 126 patients surveyed over 10 years.

Varying recoveries

A polypectomy lasts about 30 to 60 minutes and is an outpatient procedure, allowing patients to return home the same day. They should be back to a normal routine as soon as the next day. Patients who undergo an endoscopic removal of a large polyp typically require a surveillance procedure in three to six months to confirm there is no remaining tissue, Prabhu says.

Those who go in for surgery usually will remain in the hospital for about three days, but that can double if complications arise. Another potential hindrance: postoperative ileus, “a natural response to the unnatural insertion of tools into the abdomen and anesthesia, resulting in paralysis of the gut that can require a few days to resolve” Prabhu says.

The takeaway

For noncancerous polyps, the course of action favors endoscopic polypectomy when circumstances permit and expertise is available.

Even still, the dialogue should continue. “As is always the case, having an in-depth discussion with the patient and their family about their available options and the risks and benefits of each is the best approach,” Prabhu says.

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