Polyps are very common formations present in approximately 20-30% of the population and observed with imaging techniques. Polyps develop as a result of uncontrolled growth in the mucosa, which is the innermost layer of the intestine. Polyps can be present throughout the large intestine, but more commonly develop in the left colon, sigmoid colon, and rectum. Although they are benign tumors, some polyp types may turn into cancer over the years, with benign tumors. More than 90% of colon and rectum cancers develop from a single polyp. Some polyps are flat, some have stalks, their size and tissular properties may be different. These differences are extremely important for cancer development. For example;
65-80% of the polyps have tubular structures and the cancer development risk is 5%. But if the tubular polyp is larger than 2 centimeters, the cancer development risk is 45%. 10% of polyps present in patients are villous, and 45% of these polyps turn into cancer. If villous polyps are larger than 2 centimeters, 55% of patients develop bowel cancer. Similarly, in flat polyps, the risk of developing cancer is higher than polyps with stalks.
If these polyps can be removed before they turn into cancer, cancer development is prevented. Therefore, colorectal scanning programs are very important. If any, polyps are removed with regular colonoscopy and colorectal cancer development risk in the society is reduced.
Polyp Removal Procedure in Colonoscopy
Polyp development from normal colon mucosa and process of this polyp turning into cancer takes approximately 7-10 years. Therefore, it would be sufficient for individuals, who have no polyps detected in colonoscopy, to have colonoscopy every 7 to 10 years.
WHAT ARE THE SYMPTOMS OF POLYPS?
Many colorectal polyps have no symptoms. Therefore it is very important to have scanning programs and imaging examinations. Presence of polyps may cause blood in the stool for some patients. Excessive mucosa production, change in intestinal habits, diarrhea and abdominal pain are other symptoms that may be seen in the presence of polyp.
HOW POLYPS ARE DIAGNOSED?
The most common method used to detect polyps is colonoscopy. During this day case surgery, your doctor will examine your large intestine with a long, flexible, illuminated tool. If polyps are detected during this process, they are removed. It is not possible to detect polyps by other radiological imaging methods. Very large polyps can only be seen by chance in the tomography examinations performed due to other diseases. If a polyp is detected during colonoscopy, colonoscopy should be periodically repeated so that polyps can be removed or followed.
SHOULD POLYPS BE TREATED?
Since there is no visual evidence to predict whether a colorectal polyp may turn into cancer, removal of the polyps and pathological examination are necessary. A large majority of polyps can be removed during colonoscopy. In large, flat-bottomed polyps, removal by colonoscopy can be difficult, inadequate, and risky due to intestinal perforation. For this reason, some patients may need surgical treatment to remove polyp. If the rectum polyps can not be removed by colonoscopy, the polyps can be removed by TAMIS method.
In this method, the laparoscopic surgical instruments are inserted into the intestine by anal route, the polyp is cut and the formed opening is closed with suture. This way, surgical treatment where the intestine is removed through the abdomen can be avoided.
CAN POLYPS RELAPSE?
When an intestinal polyp is completely removed, the likelihood of recurrence at the same site is very low. However, the possibility of developing new polyps in the colon continues for a patient who had polyp removed. For this reason, your doctor will usually require follow-up colonoscopies within 3 to 5 year intervals following the removal of polyps.