Treatment for Colon Polyp | Treatment of Inflammatory, Hamartomas, Neoplastic Colon Polyps

Treatment for Colon Polyp

Any circumscribed mass of tissue that arises from mucosa and protrudes into the lumen of the gastrointestinal tract is called as polyp. This is a purely clinical term and this term does not signify anything histopathologically.

Types of Colon Polyps

Inflammatory polyps

  • Benign lymphoid polyps
  • Pseudo-polyps (ulcerative colitis)

Hamartomas Polyps

  • Juvenile polyp
  • Peutz-Jegher’s polyp

Hyperplastic Polyps.

Neoplastic Polps

  • Tubular adenoma
  • Villous adenoma

Familial polyposis coli.

Treatment for Inflammatory Polyps

Only excisional biopsy can diagnose this condition with certainty and is the treatment of choice.

Inflammatory polyposis is associated with ulcerative colitis or Crohn’s disease and hence that has to be treated.

Treatment for Hamartomas Polyps

Juvenile polyps

As this neoplasm is without the malignant potentially, treatment is excision biopsy.

This excision can be done easily when the polyp is within the reach of the finger. When it is beyond the reach of the finger, excision is performed either through sigoidoscope or colonoscope by cold biopsy forceps or electrothermic snare. These polyps do not recur after excision. But new polyps may appear in other place in about 10% cases after polypectomy.

Treatment for Hyperplastic Polyps

If detected accidentally, excision is indicated only for histological diagnosis.

Neoplastic polyps

  • Tubular adenoma
  • Villous adenoma

Treatment for Neoplastic Polyps

Colonoscopic removal is done of the small adenoma (tubular and villous) by cautery.

Those above 1cm are removed totally and send for histology. Large tumor with invasive malignancy located above 7.5cm from the dentate line, anterior resection is indicated.

It is always advisable to do follow-up proctoscopy at regular intervals, as recurrence is common even though the lesion is histologically benign.

Familial polyposis coli

Total abdominal colectomy, abdomino-perineal resection of rectum and anus and terminal ileostomy should be the treatment of choice. This is the only way to get rid of all polyps and discard any chance of malignant transformation.

To avoid ileostomy some surgeons would prefer to do a subtotal colectomy with ileorectal anastomosis.

 

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