Removal of polyps is an operation, how and where one removes, whether treatment is necessary, how to remove, video, methods, is it necessarily and painful?
According to statistics, 30% of benign neoplasms in the gastrointestinal tract degenerates into malignant tumors, so it is so important to perform timely removal of polyps.Today, surgery can be performed in outpatient and inpatient settings.Much depends on where the polyps are located, how many them, what size they are.There are four main methods that allow to eliminate the described pathology.Everyone has his own prescriptions.
The arsenal of modern treatment includes:
- Transanal excision of polyps.
- Electrocoagulation of the legs.
- Removal by colostomy.
- Gut resection.
Any surgery to remove a polyp involves cutting it from the stem and sealing the vessels.It can be produced in different ways.Each method is preceded by its own testimony, sometimes the methods for removing polyps are combined.
Transanal surgery to remove the polyp
This intervention is most often done.Preparation of the patient is started the day before the procedure.He is prescribed laxatives and cleansing enemas.For 20 minutes
Transanal surgery is used when the neoplasm is not more than 6 cm from the anus.Farabeuf hooks are brought out( if very far away polyps are located, the operation is performed using special mirrors).The algorithm of the surgeon's actions is as follows:
- The vascular clamp is superimposed on the foot of the tumor, similar to the fungus.
- The leg is then hemmed and bandaged with a special suture material( catgut).
- After that, the tip is cut off with a scalpel.
- A cotton swab impregnated with Vishnevsky ointment is placed on the cutting site.It will be extracted on the second day in the event that there is no severe bleeding.
The patient is taken home after taking the tampon, and does not give him any recommendations about the diet or any other restrictions.But for the place of resection to heal faster, it is worthwhile to have grinded food during the first week.
If you want to delete several polyps at once, a gradual resection is performed.In this case, the patient will go home three days later.The mucosa of the intestinal tract is shifted very well, so transanal polyps can be removed when the neoplasm is 20 cm from the anus.However, this method can be used only when education is on a thin high leg.
Electrocoagulation of the legs of the polyp
Today surgeons, in addition to the scalpel, actively use endoscopic instruments.This method is chosen when it is necessary to remove single high located mushroom-like tumors, or a scattering of small polyps on a small thick stalk.What is the essence of the method?
The patient is placed in the elbow-elbow position.An electrode similar to a lead plate with a large contact area is attached to the lumbosacral area with a patch.The other electrode, which is active, will then be used later to cauterize the neoplasm of the neoplasm.
A polyp is cut through the biopsy channel of the colonoscope, special tools are brought directly to it: a loop, a stud or forceps.A loop is used when the polyp has an oval shape and a short short leg.The forceps remove the polyp on a thick stalk.They grasp the mushroom's leg, and slightly distracted from the mucosa.This is done so that during electrocoagulation does not damage healthy areas of the intestine.Then currents are applied, which cauterize the base of the leg, blocking the blood flow in the vessels.The mushroom head is plucked out and pulled out into pieces.On the burn site there is a macula necrosis, 1x1 cm in size.
Sometimes it is not possible to remove the tumor at a time.In this case, it is extracted in parts in several steps.The interval between them is 9 days.There are many advantages to this method:
- First, with electrocoagulation, the damaged vessels are carefully sealed, so there is no risk of bleeding.
- Secondly, favorable conditions for conducting bloodless operations are created, it is possible to remove a small polyp in one session, so the question of whether a tumor should be removed should disappear with itself.
There are also disadvantages.If coagulation is not enough, there is a risk of bleeding.During electrocoagulation, it is important not to burn the intestinal wall.When perforation is allowed, or deep necrosis occurs, a bandpass operation is indispensable.And these are completely different consequences and complications, which we'll discuss below.That is why the electrocoagulation of the legs of the polyp should only be performed by a very experienced surgeon who has experience in carrying out the described manipulations.
The one who is about to undergo such an operation, wants to know if it is painful to remove the polyp by electrocoagulation.As a rule, such an operation is performed under local anesthesia, the patient does not feel pain, after the procedure, discomfort is felt, but it is connected with the preparatory process.People with a low pain threshold are prescribed pain medication.
Removing Polyps by Operation
When polyps can not be removed by the above methods, a more complex intervention is used.In particular, when large neoplasms, an unusual shape located closer to the stomach( far from the anus) are detected, a cavitary operation is revealed when malignancy is detected.It is performed under general anesthesia, as follows:
- The abdominal cavity is first opened.
- Then the doctor gently palpates the intestinal wall.He defines the place of the polyp with his hands.To facilitate the task, the surgeon's assistant inserts the rectoscope tube into the intestine before surgery, and the tumor is searched for during the operation.
- When the polyp is found, the gut compartment is isolated from both sides with special soft forceps.
- The intestine is opened in places in which there are no vessels.
- In the resulting wound, the polyp turns out and is excised with a scalpel.
- The resulting defect is closed with catgut sutures, and the cut in the intestinal walls is sutured with a double-suture.
- The abdominal cavity is cured with antibiotics and sewn tightly.
After such surgery, the patient is on perinatal diet and discharged on the tenth day after the removal of stitches.Before sending the operated home, again endoscopy of the intestine is performed.
Resection of the intestine
As you can see, the methods of removing polyps are different.There is another technology - gut resection - removal of the whole site.It is selected when the clinical picture shows a local large accumulation of neoplasms or there is a suspicion that the benign formations are ready to grow into malignant tumors.
Before surgical intervention, the localization of the lesion is specified, it is ensured that it fits within one segment of the gut.The abdominal cavity is opened, the intestine site is removed, then the two ends are sewn.
Those who are diagnosed with neoplasms in the intestine are interested in whether to remove polyps or can live with them.Doctors pay attention that removal of a polyp without anesthesia or with the help of general anesthesia is an important step in the prevention of oncology.Sooner or later benign tumors necessarily degenerate into malignant tumors.And then the treatment becomes more complex and radical.Modern medicine has techniques that allow to remove polyps not painfully, quickly and without general anesthesia.Today, a canal operation is performed only if multiple polycystosis is detected.In other cases, endoscopy or electroexcision of the polyp is used, which allows excision with the least risks and losses.
Similar polyp treatment always yields satisfactory results.Truth during the first two days there is a risk of relapse: neoplasms reappear in the same place, so the patient must go to the doctor every six months and do an endoscopy of the intestine.In addition, after electroexcision or other type of intervention, there is always a risk of complications.What can happen?
Possible complications after removal of polyp
The biggest problem is the occurrence of bleeding.The highest percentage of appearance of such complications is demonstrated by electrocoagulation of the polyp's legs.Bleeding can be insignificant and abundant, the latter always pose a threat to the life of the patient.There may be bleeding for various reasons: on the first day due to the fact that the vascular coagulation was poor, on the fifth or seventh day bleeding occurs due to the rejection of the scab.
A huge role in solving this problem is prevention.What it includes:
- Organizing proper nutrition.In the daily diet should include vegetables and fruits with coarse fiber.
- It is important to give preference to vegetable fats.
- It is desirable to completely abandon the use of alcohol and restrict smoking cigarettes.