What is a Polypectomy?

A polypectomy/ colonic polypectomy (息肉切除術) is a medical procedure used to remove polyps from the inside of the colon, also known as the large intestine. Polyps are abnormal growths that protrude from the colon's lining and can vary in size and shape. While many polyps are benign (non-cancerous), some have the potential to develop into cancer. A polypectomy is, therefore, a crucial procedure in preventing colorectal cancer, one of the most common types of cancer worldwide. 

The Purpose of a Polypectomy 

The primary goal of polypectomy is to remove polyps for histologic (tissue and microscopic) examination for diagnosis and prognostication and to prevent them from becoming cancerous. This is typically discovered through a screening method like a colonoscopy, which uses a long, flexible tube with a camera on the end to view the inside of the colon. If polyps are found, they can often be removed during the same procedure using specialised tools. 

Types of Polypectomy Procedures 

There are several techniques used to remove polyps, each depending on the size, shape, and location of the polyp: 

• Cold Forceps Polypectomy: This technique is used for smaller polyps. Forceps are used to pluck the polyp out without using electric current. 

• Hot Forceps Polypectomy: Similar to cold forceps, but involves electric current to cut the polyp and cauterise the area to prevent bleeding. 

• Snare Polypectomy: This is the most common technique for larger polyps. A wire loop (snare) is placed around the polyp's base, tightened, and then electric current is passed through it to sever and cauterise the polyp. 

• Endoscopic Mucosal Resection (EMR): Used for larger or sessile (flat) polyps, this procedure involves injecting a solution beneath the polyp to lift it away from the underlying tissue before cutting it with a snare. 

What to Expect During a Polypectomy 

A polypectomy is generally performed during a colonoscopy.

Before the procedure: 

• You will be given instructions to follow a special diet and take laxatives to clear your colon (bowel preparation). 

• Sedation is typically administered to keep you comfortable and relaxed. 

• If taking blood thinners and other medications, a period of pause prior to colonoscopy may be scheduled. 

During the procedure: 

• The endoscope is inserted through the anal opening into the colon. 

• Air or carbon dioxide is pumped in to inflate the colon for a better view. 

• Once a polyp is identified, one of the aforementioned techniques is employed to remove it. 

The entire procedure usually takes about 30 minutes to an hour, depending on the number of polyps and their characteristics. 

Recovery and Aftercare Post-Polypectomy 

Recovery from a polypectomy is relatively quick. Most patients can resume normal activities within 24 hours. However, you may experience minor symptoms such as: 

• Light bleeding, especially after the first few bowel movements post-procedure. 

• Mild abdominal pain or cramping. 

It's important to follow post-procedure instructions, which may include: 

• Drinking plenty of fluids to replace losses due to colon preparation and to maintain hydration. 

• Avoiding certain medications or supplements that can increase the risk of bleeding. 

Risks and Complications 

While a polypectomy is generally a safe procedure, like all medical procedures, it carries some risks, such as: 

• Bleeding from the site where the polyp was removed. 

• Perforation (a hole) in the colon wall, although this is rare. 

• Infection is also rare due to the bowel preparation and sterile technique used during the procedure. 

A polypectomy is a preventative procedure that plays a significant role in the fight against colorectal cancer. By removing polyps before they have the chance to turn cancerous, this procedure effectively maintains colon health. If you are due for a colonoscopy or have been advised to have a polypectomy, understanding the procedure can help alleviate any concerns and prepare you for what to expect. Always consult with your healthcare provider to get personalised advice and care. 

Read More 

• Colonoscopy in Hong Kong: What You Need to Know
• What does a Colonoscopy Procedure Involve?
• Managing Constipation in Pregnancy: The Risks of Straining and Ways to Improve Constipation

References

1. Care Online. 大腸息肉切除，您該知道的事. 8 Aug 2024 Retrieved from https://www.careonline.com.tw/2017/06/polypectomy.html  
2. Cleveland Clinic. Polypectomy. 8 Aug 2024 Retrieved from https://my.clevelandclinic.org/health/treatments/23479-polypectomy  
3. Medical News Today. What you need to know about a polypectomy. 8 Aug 2024 Retrieved from https://www.medicalnewstoday.com/articles/319757