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  • Julio Alejandro Murra Saca, MD
    Gastroenterologist

  • Tel: (503) 2226-3131, 2225-3087, 2530-3334 al 37
    Edificio Centro Scan, Colonia Médica

  • San Salvador, El Salvador

POLYPS

COLON POLYPS OVERVIEW

The presence of polyps in the colon or rectum often raises questions for patients and their family. What is the significance of finding a polyp? Does this mean that I have, or will develop, colon or rectal (colorectal) cancer? Will a polyp require surgery?

Some types of polyps (called adenomas) have the potential to become cancerous while others (hyperplastic or inflammatory polyps) have virtually no chance of becoming cancerous.

When discussing colon polyps, the following points should be considered:

  • Polyps are common (they occur in 30 to 50 percent of adults)
  • Not all polyps will become cancer
  • It takes many years for a polyp to become cancerous
  • Polyps can be completely and safely removed

The best course of action when a polyp is found depends upon the number, type, size, and location of the polyp. People who have an adenoma removed will require a follow up examination; new polyps may develop over time that need to be removed.

COLON POLYP CAUSES

Polyps are very common in men and women of all races who live in industrialized countries, suggesting that dietary and environmental factors play a role in their development.

Lifestyle — Although the exact causes are not completely understood, lifestyle risk factors include the following:

  • A high fat diet
  • A diet high in red meat
  • A low fiber diet
  • Cigarette smoking
  • Obesity

On the other hand, use of aspirin and other NSAIDs and a high calcium diet may protect against the development of colon cancer.

Aging — Colorectal cancer is uncommon before age 40. Ninety percent of cases occur after age 50, with men somewhat more likely to develop polyps than women; therefore, colon cancer screening is usually recommended starting at age 50 for both sexes. It takes approximately 10 years for a small polyp to develop into cancer.

Family history and genetics — Polyps and colon cancer tend to run in families, suggesting that genetic factors are also important in their development.

Any history of colon polyps or colon cancer in the family should be discussed with a healthcare provider, particularly if cancer developed at an early age, in close relatives, or in multiple family members. As a general rule, screening for colon cancer begins at an earlier age in people with a family history of cancer or polyps.

Polyps Rectal Colon

Rare genetic diseases can cause high rates of colorectal cancer relatively early in adult life. Familial adenomatous polyposis (FAP) and MUTYH-associated polyposis cause multiple colon polyps. Another, hereditary nonpolyposis colon cancer (HNPCC) or Lynch syndrome, increases the risk of colon cancer, but does not cause a large number of polyps. Testing for these genes may be recommended for families with high rates of cancer, but is not generally recommended for other groups.

TYPES OF COLON POLYPS

The most common types of polyps are hyperplastic and adenomatous polyps. Other types of polyps can also be found in the colon, although these are far less common and are not discussed here.

Hyperplastic polyps — Hyperplastic polyps are usually small, located in the end-portion of the colon (the rectum and sigmoid colon), have no potential to become malignant, and are not worrisome. It is not always possible to distinguish a hyperplastic polyp from an adenomatous polyp based upon appearance during colonoscopy, which means that hyperplastic polyps are often removed or biopsied to allow microscopic examination.

Adenomatous polyps — Two-thirds of colon polyps are adenomas. Most of these polyps do not develop into cancer, although they have the potential to become cancerous. Adenomas are classified by their size, general appearance, and their specific features as seen under the microscope. Adenomatous polyps are, by definition, neoplastic. Although benign, they are the direct precursors of adenocarcinomas and follow a predictable cancerous temporal course unless interrupted by treatment. They can be either pedunculated or sessile. Polyps are generally asymptomatic but may occasionally ulcerate and bleed; uncommonly, they may result in obstruction if very large.

As a general rule, the larger the adenoma, the more likely it is to eventually become a cancer. As a result, large polyps are usually removed completely to prevent cancer and for microscopic examination to guide follow-up testing.

Malignant polyps — Polyps that contain pre-cancerous or cancerous cells are known as malignant polyps. The optimal treatment for malignant polyps depends upon the extent of the cancer (when examined with a microscope) and other individual factors.

 Villous Adenoma 40%
Tubular  Adenoma 5%
Tubulo-Villous Adenoma (mixto) 22%
Inflammatories Polyps 0%

It is recommended for its potential to detect malignant therefore all ADULT FOR MORE THAN FORTY YEARS MUST HAVE A REVIEW OF YOUR STOMACH AND COLON THROUGH YOUR CONSIDERATION: DIGESTIVE ENDOSCOPY OF THE UPPER AND Colonoscopy.

By detecting this type of disease must eliminate its potential to transform into a cancer. Fortunately we have the technique of endoscopic polypectomy which is a method of removing these tumors in a simple and in the doctor's gastroenterologist.

We do it to our office without need to hospitalize the patient and he or she can incorporate into their daily activities almost immediately. For this we have advanced technology and equipment Electro cautery, laser coagulator Argon Plasma, Accessories such as injection needles endoloops tissues using special solutions to prevent bleeding, Titanium special clips and endoscopic suturing. the combination of all this technology allows us to succeed in this therapy.

Polypectomy



See this link:
CDC Department of Health and HumanServices Center for Disease Control and Prevention


Polypectomy is a procedure to remove a colon or gastric polyp.

When a colonic or gastric polyp or polyps are detected by colonoscopy, polypectomy should be done to assure that an invasive malignant tumoris not present. because there is strong evidence of a premalignant potencial for colonic polyps. 
A thin wire snare is passed through the scope and is is placed around the base of a polyp.

 


Endoscopic Polypectomy of a Rectal Polyp


Endoscopy Polypectomy of Polyp of Descending Colon


Endoscopy: Polypectomy of a Giant Polyp


Endoscopic Polypectomy of Giant Polyp


Endoscopic Resection of Giant Tubulo-Villous Mass of the Descending Colon


Colonoscopy of Juvenile Polyposis


Non Familial Juvenile Polyposis, Polypectomy of Multiple Polyps, First Colonoscopy


Non-Familial Juvenile Polyposis, Polypectomy of Multiple Polyps, Second Colonoscopy

Using computer-controlled electrocautery current, the base of the polyp is first cauterized to prevent bleeding and then the stalk beneath is severed with the wire loop.