Removal of bowel polyps
Polyps are outgrowths on the bowel lining. Most are harmless, but some may develop into cancer over years, so they are always removed when found.
Colorectal Polyps - Treatment and Information
What are colorectal polyps?
During an examination of the large intestine, colorectal polyps are found in approximately 10% of individuals. Polyps in the intestine are growths or tumors on the intestinal lining. They often have a mushroom-like shape. They can vary in size from less than 1 mm to 5 cm or more. Most are less than ½ cm. Colorectal polyps can be harmless.
Colorectal polyps can disappear spontaneously or can grow and develop cellular changes, eventually leading to cancer. The latter development typically takes 5-10 years.
Since it is not immediately possible to determine from colorectal polyps whether they will develop into cancer, it is customary at Kirurgen.dk to remove any detected polyp in the intestine. If even one polyp is found in the rectum or colon, the entire intestine must be examined for colorectal polyps. This is done at Kirurgen.dk in Charlottenlund by colonoscopy. If a colonoscopy is not feasible, CT scanning can be used instead.
With the latter, however, detected colorectal polyps cannot be removed. A CT scan in this case would require a colonoscopy, which is why it is the first choice.
What technique is used during surgery?
Modern fiber endoscopes are all equipped with a working channel. An electrical snare is passed through this channel. The snare can best be compared to a lasso, which is guided over the polyp. It can then be tightened around the stalk. The metal snare is heated and cuts/burns its way through the stalk.
Afterwards, a polyp forceps is inserted to grasp the polyp so that it can be further examined. Some polyps do not have a stalk but are "broad-based". A different technique requiring hospitalization is used for these. Very large polyps in the intestine must be removed in a hospital.
Microscopy
Colorectal polyps should ideally be examined microscopically - among other things, to see if they contain cellular changes or cancer. However, sometimes microscopy is not possible. It can be technically difficult or impossible to find and retrieve the removed polyp from the intestine. Another reason might be that - primarily for the patient's benefit - one does not want to prolong the examination unnecessarily. In these cases, it must be emphasized that the most important thing is that the polyp has been removed, and that the polyp is typically removed radically, i.e., any cellular changes typically reside in the "mushroom" head and not in the stalk. In some cases, a follow-up will be done after 1-3 months to ensure complete removal.
Complications
Complications in connection with the removal of polyps in the intestine are rare but can be serious. The stalk can contain larger blood vessels. Normally, these will be destroyed (coagulated) by the heat applied to the tissue during removal. If this does not happen, bleeding may occur. This can usually be stopped immediately, but it may be necessary to admit the patient for treatment or observation. If the intestinal wall is very thin, a hole in the intestine (perforation) can occur. This complication requires immediate surgery to close the hole. After the heat exposure, the intestine can be fragile for a period. Perforation can therefore occur up to 8 days after removal of colorectal polyps.
The heat exposure can also make the intestine more permeable to bacteria, which can lead to localized peritonitis. Symptoms will include mild localized abdominal pain. The risk is obviously greatest when removing very large colorectal polyps.
Kirurgen.dk in Charlottenlund should therefore be contacted if, after removal of colorectal polyps, you experience:
- significant bleeding from the intestine
- abdominal pain lasting more than 3 hours
- chills and fever above 38.2°C.
Overall, it is emphasized that complications occur extremely rarely. The incidence is so low that the benefit of removing possible pre-cancerous lesions far outweighs the risk.
Follow-up
Once a polyp or colorectal polyps are removed, they are microscopically examined, and their size is determined. Thereafter, most patients are offered follow-up colonoscopy every 3rd or 5th year according to specific guidelines.
Particularly At-Risk Families
Some families have a particular risk of developing colorectal polyps and colon cancer. This applies to patients with an unusually large number (hundreds) of colorectal polyps and families where several close family members either have or have had colon cancer and where at least one was under 40 when the cancer was detected. These individuals will be offered genetic counseling.
Kirurgen.dk in Charlottenlund cannot call patients for follow-up, so you must arrange for appointment booking and referral yourself.
CONTACT INFORMATION
Hans Edvard Teglers Vej 9, 1st floor. 2920 Charlottenlund
APPOINTMENT BOOKING
We are available by phone Monday-Thursday from 09-12
FOR REFERRING DOCTORS
Practice ID 215430
How to book
Online booking is not available. Call the clinic or ask your GP for a referral.
With a referral from your GP, treatment is free under the Danish public health insurance.
Call the clinic
+45 39 64 01 25
Phone hours
Phone hours: Mon–Thu 09:00–12:00
Address
Hans Edvard Teglers Vej 9, 1st floor · 2920 Charlottenlund