Our Summary

This research paper discusses the various techniques used to remove polyps from the colon and rectum. Traditional methods include endoscopic polypectomy and endoscopic mucosal resection (EMR), which involve cutting out the polyps. The current goal in this field is to make these procedures quicker, safer, and less likely to result in the polyps growing back.

The paper talks about a new method known as cold snare resection, which is becoming the standard for removing smaller polyps. This technique doesn’t cause heat damage, is quicker, and likely reduces the risk of delayed bleeding.

For larger polyps, a technique called endoscopic submucosal dissection (ESD) is used. This technique is great for treating high-grade dysplasia (abnormal cell growth that can lead to cancer) and early cancer because it has a very low rate of recurrence. But, it’s quite complex, takes longer, and costs more. Therefore, it should only be used for lesions suspected to be high-grade dysplasia or early invasive cancer.

The newest method, endoscopic full-thickness resection, uses specific devices designed for flexible endoscopy. This technique is especially helpful for treating smaller lesions that are hard to remove, for example, recurring polyps with scar tissue from previous removals.

FAQs

  1. What are the traditional methods for removing polyps from the colon and rectum?
  2. What is the advantage of the cold snare resection method for removing smaller polyps?
  3. When should the endoscopic submucosal dissection (ESD) technique be used?

Doctor’s Tip

It is important to follow the post-operative care instructions provided by your healthcare team after an intestinal resection. This may include taking medications as prescribed, eating a specific diet, and avoiding certain activities. It is also important to attend all follow-up appointments to monitor your recovery and address any concerns.

Suitable For

Patients who may be recommended for intestinal resection include those with:

  1. Large or high-risk polyps that cannot be removed using traditional methods
  2. Polyps with high-grade dysplasia or early cancer
  3. Recurring polyps with scar tissue from previous removals
  4. Polyps in hard-to-reach areas of the colon or rectum
  5. Patients with certain genetic conditions that predispose them to developing multiple polyps, such as familial adenomatous polyposis (FAP) or Lynch syndrome.

It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their individual situation.

Timeline

Before intestinal resection:

  1. Patient undergoes diagnostic tests such as colonoscopy to identify the presence of polyps.
  2. Polyps are monitored over time to assess their size, location, and potential for malignancy.
  3. If polyps are deemed high-risk or causing symptoms, the decision is made to proceed with intestinal resection.

After intestinal resection:

  1. Patient undergoes surgery to remove the affected portion of the intestine containing the polyps.
  2. Recovery period in the hospital includes monitoring for complications such as infection or bleeding.
  3. Patient may experience changes in bowel habits and diet restrictions post-surgery.
  4. Follow-up appointments and surveillance colonoscopies are necessary to monitor for recurrence of polyps or development of new ones.

What to Ask Your Doctor

Some questions a patient should ask their doctor about intestinal resection include:

  1. What type of intestinal resection procedure will be used for my specific condition?
  2. What are the potential risks and complications associated with the procedure?
  3. What is the expected recovery time and post-operative care plan?
  4. How will the procedure affect my digestion and bowel movements?
  5. Are there any dietary or lifestyle changes I should make before or after the surgery?
  6. Will I need any additional treatments or follow-up procedures after the resection?
  7. How likely is it that the polyps or lesions will recur after the procedure?
  8. What is the success rate of the chosen resection technique for my condition?
  9. Are there any alternative treatment options available?
  10. How can I best prepare myself physically and mentally for the procedure?

Reference

Authors: Dumoulin FL, Hildenbrand R. Journal: World J Gastroenterol. 2019 Jan 21;25(3):300-307. doi: 10.3748/wjg.v25.i3.300. PMID: 30686899