Intestinal polypectomy. Endoscopic gastric polypectomy preparation. Indications and contraindications for surgery

Polyps in the uterus are a fairly common occurrence in gynecology. It is associated with the pathological proliferation of endometrial tissue (and sometimes other tissues) and the formation of teardrop-shaped nodes from them, which grow into the uterine area. Quite often such tumors need to be removed, since certain types of them pose a risk of developing an oncological process. The most common operation to remove formations of this type is called polypectomy of a uterine polyp. This article describes how it is carried out, what consequences and results can be expected after it.

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Definition

Polypectopia is, literally, an operation to remove a polyp (in the case discussed in this article, an endometrial polyp in the uterus). It is carried out using various means. It is sometimes possible to coagulate pedunculated polyps; in some cases, laser treatment also helps. If the location of the formation is complex, laparoscopy or even abdominal surgery is performed. However, in most cases, hysteroscopic polypectomy is performed, which is low-traumatic and safe.

It is this simple and modern intervention that will be discussed in the article. However, sometimes it may not be effective. With multiple polyps, for example, it is sometimes more advisable to remove the uterus, especially when it comes to women of post-reproductive age. In other situations, hysteroscopy can even take place in several stages in order to remove polyps gradually.

Methodology

The technique is the most preferred at present. During this procedure, the cervix is dilated and equipment is inserted into its cavity. That is, no additional cuts are made. Thanks to this, the intervention is easily tolerated and does not pose any particular danger.

Dates

Usually, there are no strict restrictions on the timing of the operation, since the condition of the endometrium does not directly play a significant role. However, no intervention is performed during menstruation. Also, sometimes it is not advisable to carry it out at those stages of the cycle when the endometrium is very thin. In case of severe hormonal imbalance, the doctor may prescribe a specific day of the cycle based on the condition of the endometrium. But, usually, this is not required.

Equipment

The intervention is carried out using a modern diagnostic and surgical device - a hysteroscope. It consists of two systems:

The optical system consists of a camera that is inserted into an organ (in this case, the uterus) and transmits an image of the organ to the monitor of the device. It is from this image on the monitor that the doctor performs diagnostics or performs surgery;
Surgical instruments are also inserted into the uterine cavity using a hysteroscope. But it is introduced only when surgical intervention is planned. It is represented by loops, curettes, miniature scalpels, etc. It is with these instruments that the doctor performs the manipulation.

Both systems are inserted into the uterine cavity through its cervix (cervical canal), that is, no incisions are made other than the direct separation of the polyp. For this reason, the recovery period after such an intervention is minimal.

Painkiller

Uterine polypectomy can be performed under three main types of anesthesia. The choice of an appropriate method of pain relief depends on the psychological state of the patient, the complexity and duration of the intervention, as well as the presence or absence of certain contraindications. Choose one of three methods:

Mask anesthesia is the longest and is used for complex operations. Chemicals are injected directly into the respiratory tract, placing the patient into a medicated sleep. It has a number of contraindications and is quite harmful to the body;
General injection anesthesia is carried out by injection into a vein. The patient is also placed into medicated sleep, but it is less deep and more short-term. The method is used for operations of medium duration and complexity and is less harmful than the previous type;
Epidural anesthesia is used most often. It is injected into the lumbar region and deprives the lower part of the patient’s body of sensation, while she remains conscious. It does not act for too long, however, it is quite light and has few contraindications. Most often used.

Most interventions last about half an hour and there is no need for deeper anesthesia than an epidural.

Carrying out

Polypectomy of a uterine polyp is performed as follows:

The patient is placed on the operating table;
Anesthesia is given;
Sanitation of the external genitalia is carried out;
A dilator is installed on the vagina;
It is being rehabilitated;
A dilator is placed on the cervix;
It is being rehabilitated;
The uterine cavity is filled with saline;
The hysteroscope is inserted;
Surgical instruments are introduced;
The polyp is cut off;
Its parts are removed from the uterine cavity;
The saline solution is removed;
Vascular coagulation is carried out;
The instruments and hysteroscope are removed;
Sanitation of the cervix is carried out;
The expander is removed from it;
Sanitation of the vagina and external genitalia is carried out;
The expander is also removed from it.

After this, the patient is transferred to a ward, where she remains under medical supervision for several hours until the anesthesia wears off completely. After this, she can leave the medical facility.

Preparation

This intervention does not require complex preparation, although it is recommended to follow some rules before starting it:

You must abstain from sexual activity at least three days in advance;
The day before the intervention, it is better to avoid using chemical products for intimate hygiene;
The operation is performed strictly on an empty stomach - you can eat at least 8 hours before the intervention;
A week before the manipulation, it is necessary, in agreement with the doctor, to stop taking medications that reduce blood clotting or thin the blood;
In some cases, it is also not advisable to use hormonal drugs;
It is necessary to take a coagulogram and ECG to determine possible difficulties during the intervention.

What does it cure?

Polypectomy is an operation to remove a polyp, so that is what it treats. In general, hysteroscopy can be used to dissect adhesions, remove papillomas, hyperplasia, and other neoplasms. It is most often used for diagnostic purposes.

Recovery period

The recovery period lasts 4 weeks. During this time it is necessary:

Refuse sexual activity;
Do not overheat or overcool;
Avoid sports and heavy lifting;
Maintain hygiene more carefully than usual;
Avoid constipation and resist the urge to urinate.

Sometimes antibiotics may also be prescribed to prevent infection. Hormonal medications are prescribed to reduce the likelihood of relapse. Therefore, it is necessary to follow the doctor's instructions.

Polyps are benign tumors that grow into the lumen of hollow organs and are distinguished by a wide variety of shapes and sizes. Quite often, polyps affect the mucous membrane of the stomach and intestines. The risk of their occurrence increases in older people, smokers, with type 2 diabetes mellitus, obesity, and also with a family history. Polyps are often detected accidentally, during endoscopic examination (gastroscopy and colonoscopy), performed on the recommendation of a gastroenterologist.

Polypectomy

Neoplasms carry the risk of becoming a malignant tumor and therefore must be removed. If a single polyp measuring less than 0.5 cm is detected, expectant management can be used - such a polyp can be observed over time by performing an endoscopic examination at least once a year, which will prevent the development of complications. In all other cases, polypectomy is a necessary measure.

Polypectomy with endoscopic examination -
15,000 - 40,000 rub.

(duration of procedure)

An operation to remove polyps from the stomach and intestines (polypectomy) is a fairly common surgical procedure. The procedure, at first glance, is simple and minimally invasive, because it is performed using endoscopic equipment, that is, without incisions.

However, despite the apparent simplicity of the manipulation, the removal of polyps has a number of important nuances on which the further prognosis of the disease depends. If patients tolerate this procedure quite easily and with a minimal recovery period, then the doctor is required to have extensive practical experience in performing diagnostic and surgical procedures. The type of endoscopic equipment used also matters.

If polyps are detected, endoscopists at the CELT clinic can perform a polypectomy during an endoscopic examination, provided that the size of the polyp does not exceed 10 mm. If the tumor turns out to be large, the operation is postponed and performed after additional examinations. If necessary, to decide on the extent of intervention, a biopsy of the lesion is first performed for histological examination.

Indications

polypoid formation of the stomach or colon more than 5 mm;
polypoid formation less than 5 mm, suspicious for malignancy.

Contraindications

blood clotting disorder;
acute inflammatory process of the gastrointestinal tract;
acute infectious diseases;
critical condition of the patient.

Main types of polyps

There are three main types of polyps:

Adenomatous. If we rely on statistics, then this type of neoplasm is the most common and more often than others undergoes malignancy. Every second inhabitant of the planet over 60 years of age suffers from polyps in the stomach and intestines, the size of which usually exceeds 1 cm.
Serrated. The likelihood of transformation into cancer directly depends on the size of these polyps and their location. So, the smaller the tumor size, the lower the risk of degeneration. Localization of a neoplasm in the upper parts of the gastrointestinal tract increases the likelihood of malignancy, while its location in the lower parts of the colon rarely undergoes malignancy.
Inflammatory. They are not polyps in the true sense of the word. They occur against the background of various inflammatory diseases (for example, Crohn's disease, ulcerative colitis, etc.). Despite the low risk of transformation into cancer, this type of polyp creates favorable conditions for the growth of cancer cells.

How is the operation performed?

One of the important factors determining the tactics of polypectomy is the size of the tumor:

Polyps up to 0.5 cm. In this case, removal of the neoplasm can be carried out at the stage of diagnostic examination - fibrogastroscopy or colonoscopy.
Polyps larger than 0.5 cm. The operation begins only after additional examination methods have been carried out, excluding the presence of contraindications. After polypectomy, provided that a tumor up to 3 cm in size is removed, the stay in the clinic ranges from several hours to 2-3 days. Active monitoring of the patient continues as long as the patient’s general condition requires.

At the end of the procedure, the removed material is always subjected to histological examination.

Innovative equipment

The multidisciplinary CELT clinic is equipped with exclusively modern equipment. To diagnose polyps of the gastrointestinal tract, he uses endoscopic equipment from Olympus, a leader in this field. The accuracy of diagnosis and quality of treatment is largely due to the high level of technical equipment of the clinic.

Why choose CELT clinic?

Medical personnel. The high level of qualifications and many years of experience of our specialists indicate that you can trust us with your health.
Manufacturability. Advanced medical technology allows all diagnostic and therapeutic procedures to be carried out at a very high level.
Accuracy. You can be confident in the reliability of the results of histological examination of the collected material.
Save time. The entire course of treatment, starting with a clinical examination, examination of the patient and ending with a series of therapeutic measures, including highly specialized care, takes a minimum amount of your precious time.

Colon polypectomy - removal of polyps from the inner lining of the colon. A colon polyp is a growth of tissue. Some types of polyps can develop into cancer. Most polyps can be removed during a colonoscopy or sigmoidoscopy.

Reasons for removing colon polyps

The purpose of the operation is to remove the polyp. This is done to prevent cancer.

In rare cases, large polyps can cause painful symptoms such as rectal bleeding, abdominal pain, and bowel problems. Removing the polyp will relieve these symptoms.

How is colon polyps removed?

Preparation for the procedure Before the procedure, your doctor will likely prescribe the following:

physical examination;
review of medications taken;
checking stool for occult blood;
diagnostic colonoscopy or sigmoidoscopy - examination of the inside of the intestine using an endoscope.

The colon must be completely cleansed before the procedure. Any stool that remains in the bowel will block the viewing area. This preparation may begin several days before the procedure. Cleaning methods may include:

enema - liquid is injected into the rectum to stimulate bowel movements;
laxatives - medications that cause soft stools;
you need to take clear liquid food;
taking large amounts of fluid to stimulate bowel movements.

In anticipation of the procedure:

The patient may be asked to stop taking certain medications a week before the procedure:

anti-inflammatory drugs (for example, aspirin);
blood thinners such as clopidogrel or warfarin;
supplements or vitamins containing iron;
You can eat a light meal the night before. You should not eat or drink after midnight before surgery;
If you have diabetes, you should consult your doctor if you need to take a dose of insulin;
You need to arrange a trip home after the procedure.

Description of the procedure for removing colon polyps

The patient will be asked to lie on their side or back. An endoscope, which is a long flexible tube with a camera at the end, will be inserted through the anus. It will slowly push down the rectum and into the colon. Air is pumped through the device to open the colon.

Using a camera, the doctor finds the polyp. The polyp will be cut off with a special tool. In some cases, polyps can be destroyed using electric current. Electrical current is also used to close the wound and stop bleeding. The polyps are sent to the laboratory for examination. When the doctor has completed the operation, the instruments are slowly removed from the intestines.

How long will it take to remove colon polyps?

30-60 minutes.

Will it hurt?

Special cleaning solution, laxatives, and/or enemas often cause discomfort. There is usually no pain during or after the procedure. The patient may feel pressure, bloating, and/or cramping due to air being pumped into the colon. This discomfort will disappear once the gas is released. Your doctor may prescribe pain medication to relieve discomfort.

Caring for the patient after removal of colon polyps

Home care Full recovery usually takes about two weeks. To ensure normal recovery, be sure to follow your doctor's instructions, which may include:

You should not drive, operate machinery, or make important decisions on the day of the procedure until the sedative wears off.
You can return to normal food the next day. You should avoid drinking coffee, tea, carbonated drinks, alcohol and eating spicy foods for at least 2-3 days after surgery as this may irritate your digestive system.
You can return to normal activities as soon as your condition improves. Most people feel quite well the next day.
You should ask your doctor about when it is safe to shower, swim, or expose the surgical site to water.
In the future, you should plan to have periodic colonoscopies. It is important to check for recurrence of polyps.
The doctor will discuss the results of the procedure on the day of surgery or the next day.

Contacting your doctor after colon polyp removal

Signs of infection, including fever and chills.
Redness, swelling, increased pain, bleeding or discharge from the rectum (up to 150 ml of blood per day can be expected for 3-4 days after polypectomy).
Black, tarry stool.
Severe abdominal pain.
Inability to pass gas or stool.
Cough, shortness of breath, chest pain, or severe nausea or vomiting.

A gastric polyp is a benign neoplasm, which is a small lump on a stalk. Removal of the tumor is carried out in situations where conservative treatment is not effective, and the condition is complicated by bleeding or there is a threat of the tumor becoming malignant. So, polypectomy - what type of operation is it?

Stomach polyp

A gastric polyp is a benign neoplasm on a pedicle that occurs against the background of inflammatory processes. Until recently, polyps were considered a pathology of older people, but in recent years the process is often detected at a young age.

The danger of the disease is due to the tendency to degenerate into cancer, as well as ulceration of the surface of the polyp, which leads to chronic bleeding and anemia.

Important. Most often, neoplasms are localized in the antrum or pylorus. Usually a polyp is formed singly. Polyposis - multiple formation of growths - is extremely rare.

Polyps can be of different shapes and sizes, formed flat or pedunculated

Since this pathology has a tendency to malignancy, removal of polyps in the stomach is necessary to prevent the malignancy of the process.

Reasons for formation

The risk group for polyps includes men over 40 years of age suffering from chronic gastritis. Heredity also plays a significant role.

How to recognize a process

The formation of polyps in the early stage is often asymptomatic. When a neoplasm forms against the background of a gastrointestinal disease, the clinical picture of the primary disease appears.

Symptoms of gastrointestinal diseases:

heaviness and pain in the epigastric region;
change in appetite;
nausea and vomiting (in later stages of the disease are not associated with food);
belching and heartburn;
flatulence;
diarrhea.

Large tumors are prone to bleeding, which is manifested by vomiting blood. When a neoplasm grows in the duodenum, the process manifests itself as cramping pain in the epigastric region and abdomen.

FGDS is the most informative study that allows you to identify polyps and assess their condition visually

Diagnosis of polyps is carried out using fibrogastroscopy, the main advantage of which is the ability to take material for histological examination. After completing the diagnostic measures, the doctor decides on the method of treating the patient.

Treatment

Conservative treatment of polyps is accepted only as a preparatory step for gastric polypectomy to reduce the inflammatory process. Complete treatment is only possible by removing the tumor with further treatment of concomitant diseases of the digestive tract to prevent the re-formation of polyps.

In order to remove tumors, abdominal or endoscopic surgery is performed; it is also possible to use laser treatment and electrocoagulation methods (the last 2 operations are rarely used).

After the doctor decides on a polypectomy, the patient must undergo a full examination. If necessary, treatment of concomitant and background diseases is carried out.

Benign tumors of the stomach should be removed or be under the strict supervision of a gastroenterologist; when a polyp degenerates into a malignant tumor, surgical removal of the formation occurs along with gastric resection

Important. Surgical intervention is possible only against the background of the absence of inflammatory processes in the body and with the full functioning of the cardiovascular and respiratory systems. If any diseases are present, all systems are treated and normalized.

Endoscopic polypectomy

Endoscopic gastric polypectomy is considered the safest type of surgical treatment. Endoscopy of the polyp is carried out when the tumor size is no more than 30 mm in the absence of suspicion of malignancy.

Removal of pathology using an endoscope is carried out in 3 stages: capture of the tumor with a rigid loop, cutting and extraction of the removed growth

Progress of the procedure:

The patient drinks a solution of sodium bicarbonate to eliminate gastric mucus (providing access to the polyp).
An endoscope is inserted into the stomach cavity. This can be done in 2 ways. During laparoscopic surgery, thin punctures are made in the abdominal cavity (without excision of tissue) through which the operation is performed. During an operation using flexible endoscopes, penetration into the polyp occurs as during gastroendoscopy through the esophagus under local anesthesia of the oral cavity (dicaine solution).
The tumor is captured with a rigid metal loop, cut and removed using an endoscope.

Important. When a flat growth is formed during endoscopic surgery, an artificial stem is created for it.

Endoscopic removal is not possible if blood clotting is reduced or the patient is in serious condition, when any intervention can worsen the condition. Endoscopic polypectomy is not advisable in case of multiple formation of polyps, especially if the stomach and intestines are affected simultaneously. In such situations, more serious abdominal surgery is performed.

After endoscopic polypectomy, hospitalization is usually not required, except in the elderly. However, complications are possible (no more than 1% of all those operated on): bleeding or perforation of the stomach wall. If complications occur, surgical treatment is necessary.

Polypectomy with coagulation

The procedure is identical to endoscopic surgery with the only difference that instead of a metal loop, biopsy forceps equipped with an electric current for cauterization are used to remove the pathological formation.

Laser treatment

Laser polyp removal is used extremely rarely. The technique is the same as endoscopic surgery. However, a focused laser beam is used for removal. Burning occurs layer by layer.

Important. Laser treatment is inconvenient for treating polyps. It cannot be used for polyps larger than 10 mm or having a thin and long stalk. The disadvantages of laser polyp removal are: impaired visibility during burning due to smoke, difficulty focusing the beam due to intestinal peristalsis.

At the same time, it is not possible to conduct a histological examination due to the lack of a device for extracting a biopsy specimen.

Laser or electrocoagulation removal of a polyp is carried out like endoscopy, but cauterization of the cut is used using a laser or electricity

Abdominal surgery

Abdominal surgery is chosen for multiple polyps or formations larger than 30 mm. suspicion of malignancy also requires abdominal surgery.

How to remove polyps in the stomach during abdominal surgery:

the patient is “put to sleep” under general anesthesia;
a longitudinal incision is made on the abdominal wall;
gastric juice is completely removed;
the polyp is removed with a scalpel and sent for histological examination;
further tactics depend on the results of histology. If there are no cancer cells, the stomach is sutured and the operation is completed. If a malignant process is confirmed, gastric resection is performed. If necessary, the entire stomach can be removed.

The choice of abdominal surgery is justified when atypical cells are identified and when multiple polyps form

Important. When identifying atypical cells, resection of the affected area of the stomach is required in order to prevent the development of metastases throughout the body, as well as the recurrence of a tumor at the site of the removed neoplasm.

Recovery period

After surgical treatment, the body needs time to recover. During this period, the patient should be under the supervision of the surgeon who performed the operation.

With endoscopic polypectomy, gastroendoscopy is performed 2 weeks from the day of surgery. If there was a more radical intervention, the study is done after the operated surface has healed. During the examination, the doctor assesses the condition of the mucous membrane of the operated area, the presence of remaining polyps and determines complications (whether present or not). Endoscopic monitoring is carried out over time after 3, 6 and 12 months. Further observation will depend on the results of the study. In the absence of new polyps and mucosal disorders, it is enough to undergo control once every 2 years. If new tumors form - every 3 months before surgery.

During the recovery of the stomach after surgery, strict adherence to a therapeutic diet is required.

Nutrition after polypectomy

The diet after removal of a polyp in the stomach is aimed at restoring the main digestive organ after surgery. Nutrition should be gentle chemically, mechanically, thermally and at the same time contain all the nutrients the body needs.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Previously, it was believed that removal of polyps in the intestine was advisable only for large or multiple neoplasms. However, statistics on the degeneration of these benign tumors into malignant ones (10-30% of cases) showed specialists that for cancer prevention it is important to get rid of even small polyps.

Today, endoscopic treatment is used to remove polyps in the large and small intestine, except in cases where the tumor is located in parts of the intestine inaccessible to the endoscope. Large and multiple polyps with a high risk of degeneration into cancer are an indication for segmental resection surgery.

Treatment tactics

If a small polyp is detected, watchful waiting may be prescribed– the doctor monitors the dynamics of tumor growth throughout the year, and if no significant changes are detected, surgery to remove polyps is not performed. However, in this case, it is imperative to continue to be examined regularly in order to eliminate the risk of degeneration in time.

Due to the psychology of Russian patients, in most cases, instead of expectant management, endoscopic removal is immediately prescribed. People believe that there is no need to worry about small polyps and ignore doctors’ orders for repeated examinations, so specialists immediately take a radical approach to the problem - this is the safest option. Even a small tumor can quickly become malignant.

There is no conservative treatment for intestinal polyps - it is simply ineffective.

If there are other possible complications of polyps - bleeding, incessant diarrhea, excessive mucus secretion or severe inflammatory processes - wait-and-see tactics are not used, surgery is prescribed immediately.

Removal of polyps in the colon

In most cases, removal of polyps in the rectum with an uncomplicated course is carried out endoscopically during colonoscopy. The same treatment is used for sigmoid colon polyps. The operation is called polypectomy.

Preparing for surgery

In preparation for surgery, it is necessary to cleanse the intestines. To do this, the day before the procedure, the patient is advised to drink at least 3.5 liters of clean water; the diet includes only liquid, light food. The evening before the procedure you should not eat or drink. A cleansing enema may be prescribed.

Sometimes a special solution with water and a laxative is prescribed. Most often this is a solution of polyethylene glycol (4 liters), which is drunk for 180 minutes the evening before surgery, or lactulose preparations (solutions of Duphalac or other medications containing this component). In the second case, 3 liters of liquid are divided into two doses - before lunch on the day before surgery and in the evening. After taking these solutions, you should experience diarrhea, possibly bloating and pain in the abdomen.

If the patient is taking blood thinning medications (Aspirin, Warfarin, Ibuprofen, etc.), it is important to inform the attending physician. Most likely, you will have to give them up 1-2 days before the colonoscopy.

Carrying out a polypectomy

colonoscopy

Colonoscopy is performed only in specially equipped rooms. The patient lies on the couch with his left side, and anesthetic drugs are administered. Access to the polyps is carried out through the anus; a flexible and thin endoscope (colonoscope) with a small flashlight and a video camera is inserted into it, which allows you to visually monitor the progress of the operation.

If the polyp is flat, a special drug (often adrenaline) is injected into it, which lifts it above the surface of the mucosa. The tumor is removed using an instrument with a diathermic loop at the end. They pick up the base of the polyp and cut it, while applying electric current to cauterize the damaged area and prevent bleeding.

Important! The excised polyps are necessarily sent for histological analysis, only after which a final diagnosis is made. If atypical cells are detected, indicating tumor malignancy, the patient is prescribed a partial intestinal resection.

In rare cases, laser surgery is used to remove polyps. It is not as effective as colonoscopy, since it is not possible to obtain tissue material for histology (the polyp is simply burned to the root) and there are difficulties with visual control (due to smoke).

Transanal excision of polyps

If colonoscopic surgery is not possible, direct surgery through the anus may be prescribed. This treatment is not possible if the polyps are located further than 10 cm from the anus.

Before the operation, local anesthesia is performed according to Vishnevsky, and sometimes general anesthesia is prescribed. A rectal speculum is inserted into the anus. The base/leg of the polyp is excised with special instruments (Billroth forceps), the wound is sutured with 2-3 catgut knots.

If the polyp is located in the interval of 6-10 cm from the hole, then during the operation, after inserting the rectal speculum, the sphincter is relaxed with the fingers, after which a large gynecological speculum is inserted, which is used to move the intestinal wall not affected by polyps to the side. Then a short mirror is inserted and the tumor is removed using the same procedure. Polyps are sent for histology.

Segmental resection of the large intestine

This operation is prescribed only if there is a high risk of malignancy of the colon tumor or the presence of multiple closely located polyps. It is performed under general anesthesia. Depending on the location of the tumors, the type of operation is chosen:

Anterior rectal resection. Prescribed for tumors above 12 cm from the anus. The doctor removes the affected parts of the sigmoid and rectum, and then sews the remaining parts of the intestine together. Nerve endings, healthy urination and sexual function are preserved, feces are kept normally in the intestines.
Low front. It is used when the tumor is located 6-12 cm from the anus. Part of the sigmoid colon and the entire rectum are removed, the anus is preserved. A temporary “reservoir” is created to hold the stool and a stoma (part of the intestine is drained out through the peritoneum) is created to prevent excrement from entering the healing sutured area of the intestine. After 2-3 months, a reconstructive operation is performed to close the stoma and return normal bowel function.
Abdominal-anal. It is carried out when the tumors are located at a distance of 4-6 cm from the anus. Part of the sigmoid colon, the entire rectum, and possibly part of the anus are removed. A stoma is formed, which is closed after 2-3 months.
Abdominoperineal. Indicated when the tumor is located close to the anus. Part of the sigmoid colon, the entire rectum, anus and part of the pelvic floor muscles are removed. A permanent stoma is formed, since it is impossible to maintain the function of normal bowel movement (the sphincter is cut out).

Important! When a permanent stoma is opened, the patient is given recommendations on how to care for it and organize life activities. In most cases, a high quality of life can be achieved despite the inconvenience and aesthetic defect.

Treatment of polyps in the small intestine

Single small pedunculated polyps of the small intestine are removed using enterotomy; in the presence of other neoplasms, resection of the small intestine is indicated.

Performing an enterotomy

This surgery is dangerous and much more serious than endoscopic methods and requires highly qualified surgeons. Stages of implementation:

The patient is placed under general anesthesia.
A transverse incision is made over the desired area of the small intestine with a scalpel or electric knife.
Polyps are excised through the incised area and sent for histology.
All incisions are sutured.

After the operation, the patient must remain in the hospital under the supervision of a surgeon and gastroenterologist. Bed rest is required, painkillers are prescribed to relieve pain, and a strict diet is followed. If the doctor is insufficiently professional, narrowing of the small intestine and bleeding may occur.

Segmental resection of the small intestine

The operation is performed open or laparoscopically, the latter is preferable because it has fewer negative consequences - the scars are smaller, the likelihood of infection is lower, and the patient’s recovery is quick. Preparation for the intervention is carried out according to the standard scheme described above. Execution proceeds as follows:

The operation lasts up to 3 hours, after which the patient is gradually removed from anesthesia (up to 2 hours). Recovery requires 3-7 days in hospital. When performing an open resection, one large incision is made in the peritoneum, rehabilitation requires up to 10 days in the hospital, otherwise there are no differences.

Rehabilitation period

Within 2 years after removal of polyps, the risk of relapse and bowel cancer is high. Patients are advised to undergo regular examinations - every 3-6 months. The first examination is scheduled 1-2 months after the operation. Subsequently (from the third year after treatment), examinations are required every 12 months.

Do not ignore preventive examinations, come to the doctor at the appointed time, follow his recommendations.
Give up bad habits; smoking and drinking alcohol are extremely undesirable.
You should not engage in heavy physical labor or lift weights - this will increase the risk of bleeding.
Avoid hypothermia and overheating, do not stay in the sun for a long time, avoid solariums and follow the prescribed hygiene measures.
Try to limit stress and prevent overwork. Healthy rest plays a significant role in recovery.

During the rehabilitation period it is necessary to follow a diet. During the first week after endoscopic surgery, you should eat crushed food, purees, and soft liquid porridges. Tough and difficult to digest foods rich in coarse fiber are excluded. Meals should be fractional - eat up to 6 times a day.

Important! After open operations, the diet is prescribed by the doctor; it is very strict and excludes almost all food.

You will need to see a doctor immediately if you have the following complications:

Fever, chills;
Heaviness in the abdomen, nagging pain;
Redness, swelling in the anus;
Blackening of the stool, blood during bowel movements, constipation;
Nausea, vomiting and other signs of intoxication.

This may indicate dangerous consequences of the operation, which include bleeding, perforation of the intestinal wall, intestinal obstruction, enterocolitis, the formation of fecal stones or malignancy.

Average prices

The cost of operations to remove polyps in the intestines varies greatly depending on the clinic, the doctor’s qualifications and the amount of work. The approximate price range is presented in the table.

Free treatment is possible in public clinics under the compulsory medical insurance policy. Help under the VMP program is also possible if the malignancy of the polyp is confirmed.

Patient reviews often mention doubts about the need for surgery to remove polyps in the intestines. However, doctors unanimously argue that its implementation is justified, since it significantly reduces the risk of developing cancer. People who have undergone minimally invasive surgery are satisfied with the results and speed of rehabilitation. The main thing in treatment is to find an experienced and reliable doctor whose help you can rely on.