Colonic polyp
April 28, 2010 | 30,00 EUR | answered by Dr. med. Olaf Stephan
Dear Dr. Stephan,
Thank you very much for your prompt response.
You also wanted the endoscopic findings: of the mentioned adenoma
"Excision of a approximately 3 cm large short-stemmed lumen-filling polyp in the loop-rich sigmoid colon, difficult due to its angulated position, therefore excised in two parts, the wide stem is secured with multiple hemostasis clips to prevent bleeding. Macroscopically, this excision appears complete."
Dear Inquirer,
Now I can try to answer the rest of your question as specifically as possible. Apparently, a complete colonoscopy was performed and only one polyp was found, so follow-up examinations within a period of 5 years seem justified. The fact that a quite large, broad-based polyp located in a difficult location for extraction could be removed speaks clearly for the professional skill of the endoscopist, whom I would like to expressly commend at this point, and I also believe that you can rely on his professional advice. The polyp had to be removed because, regardless of the histology, it would likely become an obstruction over time (with further growth), potentially resulting in a bowel obstruction. To be specific, I recommend a short-term follow-up examination (4 to 6 weeks) for our patients in this constellation of findings, as already mentioned in my initial explanations. The hemoclips will likely have passed naturally by then. Explanation: To remove a broad-based polyp from the colon, it must first be injected with saline solution so that it lifts significantly from the intestinal wall due to the depot effect, allowing it to be well grasped and extracted with the loop. After the extraction of large polyps, scarring may occur over time, making it impossible to lift the mucosa against the muscle of the intestine when injecting the tissue, and endoscopic resection (which is always the least invasive measure) is no longer applicable, only surgery. This scarring process takes some time, which is why short-term monitoring is justified, as the histological findings still suggest remnants of polyps in the mucosa. I hope I have been able to explain the procedure to you clearly, as the removal site is located in the sigmoid colon (relatively far from the end of the intestine), it will also be a minor examination. At this point, I would like to point out that I can only offer advice and give my personal professional opinion; you should definitely also speak with your gastroenterologist, who seems very competent.
P.S. It saddens me a bit that you have to pay so much money for my advice; I would have told you the same for less cost.
Best regards, O. Stephan.
