Polypectomy and the Early Detection of Colon Cancer

Illustration of a polyp being removed
SEBASTIAN KAULITZKI/Getty Images

Polypectomy is a term used to describe a minimally invasive procedure in which doctors remove abnormal growths of tissue, called polyps, from inside your colon. In addition to being a therapeutic procedure, a polypectomy is used as a means to assess whether a growth is cancerous, precancerous, or non-cancerous.

Purpose

You may need a polypectomy if you have a polyp inside your colon. A polyp may be discovered during a colonoscope. It may also be detected during a non-invasive imaging test, such as a CT, ultrasound or MRI scan when you are being evaluated for symptoms, such as weight loss or bleeding. A polypectomy is performed whenever a polyp that needs to be removed is found. A polyp remaining inside the colon can bleed, grow, or become cancerous.

Colonoscopy

A polypectomy is commonly performed during a colonoscopy. A colonoscopy is a screening test in which a long, flexible colonoscope, which is connected to a camera, is inserted into the rectum to check for abnormalities in the colon. A colonoscopy is a routine exam recommended for adults 50 years of age or older to check for any growths that may indicate cancer.

Biopsy

Often, when a polyp is removed, it is examined under a microscope like a biopsy, so that you and your doctor will know if it was cancerous and whether there is any evidence that any remaining tissue also needs removal.

Risks and Contraindications

A polypectomy can cause bleeding, a perforation, or an infection. If you need a polypectomy, your doctor may recommend that you discontinue blood thinners prior to the procedure.

If you have an infection of your gastrointestinal system, a polypectomy can trigger the spread of infection, so it is likely that your doctor will want you to wait until after the infection has resolved before you have a procedure.

A perforation, in which the bowel is cut, is a rare complication of the procedure itself. If this happens, you would need emergency surgery to repair the lacerated bowel.

Before the Procedure

If you have a polyp discovered during a colonoscopy, it is likely that you will have it removed during your colonoscopy, not at another time. Usually, a consent for a colonoscopy also includes a discussion of the possibility of a polypectomy, as well as a consent for a polypectomy in case it is needed so that you don't have to go through the process of preparing for another procedure again.

If your polyp is discovered on an imaging examination, such as a CT scan, then your doctor will explain the process of a colonoscopy with a polypectomy when discussing your test results.

Timing

A polypectomy should take between 20 minutes to an hour. You will be given medication that makes you a bit sleepy, and some people continue to feel groggy from the medication until after a good night's sleep, so you should be prepared to take it easy for the rest of the day after your procedure.

Location

A polypectomy is generally done in a GI procedure suite that is equipped with a colonoscope, as well as a screen that your doctor uses to visualize the images.

What to Wear

You can dress comfortably. You will be asked to undress from the waist down and to wear a gown throughout your procedure.

Food and Drink

To prepare for the procedure, you will be asked to undergo thorough bowel preparation a day or two in advance to ensure that your colon is clear and free of any visual obstruction. This can involve the use of a laxative, enema, and a clear food diet. A clear fluid diet includes clear broths, jello, and juice (without pulp).

Cost and Health Insurance

In general, most health plans cover colonoscopy and polypectomy, but you may need pre-authorization. If you are paying for the procedure out of pocket, the cost will be in the range of $1500 to several thousand dollars.

What to Bring

You should be sure to have someone who can drive you home after the procedure, as you may be too groggy to drive safely.

During the Procedure

Your polypectomy will be performed by a gastroenterologist, who is a doctor specialized in diseases of the gastrointestinal system. You will also have either a nurse or an anesthesiologist (a doctor specialized in sedation) helping with the procedure.

On the day of the procedure, you will have to sign in and fill out forms consenting to the procedure and permitting payment for your procedure.

Throughout the Procedure

You will meet with an anesthesiologist or a nurse, who will ask if you have any allergies or prior adverse reactions to anesthesia. You will be given a medication to relax you and to make you sleepy, either by mouth or intravenously (IV). You will most likely remain awake during the procedure, which can take anywhere from 20 minutes to an hour.

Once you are prepped and dressed in a hospital gown, you will be laid on your side on the examining table with your knees pulled toward your chest. The doctor will insert the colonoscope into your rectum. You may feel a slight pressure, but it shouldn't hurt. Depending on the room set up, you may be able to see the screen that your doctor is viewing.

Once your doctor locates the polyp or polyps, you will have it removed with one of two different types of polypectomies. You may have a local anesthetic injected in the area to prevent pain.

There are two different types of polypectomies that may be used:

  • Snare polypectomy is a technique in which the doctor loops a thin wire, called a snare, around the base of the polyp and uses heat to simultaneously cut off the growth and cauterize (stop bleeding) the wound.
  • Piece-meal polypectomy is used to remove large growths that would otherwise be removed by surgery. If a person is unable to undergo bowel surgery, this technique removes the growth piece by piece during the course of a colonoscopic procedure.

The growths themselves can be small and uncomplicated or they may be large pedunculated polyps that grow up on stalks like a mushroom. If you have bleeding, your doctor may need to place a suture to stop the bleeding.

After your procedure, your doctor will remove the colonoscope, and will give you a chance to rest and clean up.

Once removed, the polyps are sent to a pathology lab to assess whether there is any sign of colon cancer. Results are usually available within a few weeks.

After the Procedure

After your polypectomy, your doctor or nurse will give you instructions explaining what to expect and the symptoms to look out for. It is not unusual to feel groggy and unsteady on your feet. As such, it is advised that a friend or family member drive you home.

While there is usually little pain following the removal of a smaller polyp, pain medication may be prescribed if the removal has been extensive or if your pain is severe.

The risks of polypectomy are similar to those of the colonoscopy and can include rectal bleeding and perforation of the bowel. Will these complications are considered rare, you should contact your doctor immediately if you experience any of the following adverse symptoms:

  • Fever or chills
  • Heavy bleeding (more than a teaspoon at a time)
  • Severe abdominal pain or bloating
  • Vomiting
  • Lightheadedness, dizziness, or fainting

Interpreting Results

The results of a polypectomy include a report about the type of lesion that was removed, as well as whether the whole lesion was removed. The report will describe whether there were any cancerous cells or pre-cancerous cell, or whether the tissue was completely normal.

In addition, the report will include a description of whether the margins, which are the edges of the lesion, were normal or whether they contained cancerous or pre-cancerous cells. When there are areas of concern, normal margins suggest that the concerning areas were fully removed, while margins that contain worrisome cells suggest that the cancerous or precancerous lesions were not fully removed.

Follow Up

A polypectomy does not need to be regularly repeated. However, if there are areas of concern that were not fully removed, your doctor may schedule you for another procedure to remove remaining lesions or may order follow up imaging studies.

If there was no evidence of cancer noted on your lab reports, you will need to continue to have routine colonoscopies.

A Word From Verywell

A polypectomy can be frightening because it is a procedure, not a screening test. While a polyp certainly is something that requires attention, the vast majority of polyps are benign, and, when removed in a timely manner, do not pose a danger to your health.

Was this page helpful?
View Article Sources