Polypectomy

Polypectomy is an endoscopic medical intervention, which is commonly performed by gastroenterologists who remove polyps in the digestive tube (especially in the stomach and the colon).

 

Polyps are local outgrowths of mucosa of hollow organs. There exist tumor and non-tumor polyps; the tumor polyps can be divided into benign and malignant. However, clear assessment of the character of a particular polyp can be done only by complete histological examination, which can be done only after the polyp removal.

Introduction

It is necessary to obtain the polyp for histological examination. It is possible to only take a biopsy by forces, but this gives us only information about a small part of the polyp. Therefore, it is advisable to directly remove larger polyps by polypectomy and send the whole tissue for histological examination.

Endoscopic polypectomy

Own polypectomy is performed during an endoscopic procedure (upper GI endoscopy and colonoscopy). The polypectomy loop is inserted through the working channel of the endoscopic device. The loop is put over the polyp, tightened and the polyp is cut by a short electric discharge, which is sent into the loop. After the procedure, other tools are used to obtain the removed polyp and take it out of the digestive tube. In case that the polyp is larger and sessile, the local mucosa is infiltrated by special blue dye and epinephrine. This prevents bleeding and raises the polyp to make it easier to remove. The rest of the procedure is similar – the polyp is cut off.

Preparation

The preparation depends on the endoscopic approach – either upper GI endoscopy or colonoscopy (see the related article). Polypectomy may cause bleeding and any anticoagulation therapy should be therefore discontinued before the procedure, of course only when possible and after consulting a doctor.

Further approach

The polyp is sent for histological examination, where the doctors can accurately describe if the polyp is of a tumor origin and if this is confirmed, then if it is benign or malignant. Further approach depends on the result.

Disadvantages

The risk of polypectomy increases with the size of the polyp. Typical risks include bleeding and the most serious is intestinal perforation. Bleeding must be usually solved by repeated endoscopy. The perforation may be closed endoscopically or surgically.

Conclusion

Polypectomy is a very important procedure that removes polyps of the gastrointestinal tract and allows their histological examination. Many intestinal polyps are in fact benign tumors that may change into the malignant colorectal cancer and their early removal may be a life-saving procedure from the long-term point of view.