You May Not Need Surgery for Large Colorectal Polyps
All benign colorectal polyps must come out to prevent cancer. But surprisingly large polyps can be removed during colonoscopy — so you may not need to lose any part of your colon.
Colorectal polyps don’t always become cancers. But the bigger ones are the most dangerous — and the most difficult to remove.
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“The trick is to make sure that, when surgery is recommended for a large polyp, it is really needed.”
Screening colonoscopy usually finds polyps and allows doctors to remove them (a procedure called polypectomy). But not all large polyps can be removed during colonoscopy.
“Some patients with large benign polyps are told they have to have surgery — and that part, or sometimes all, of the colon must come out,” he says.
Polypectomy is less invasive, less dangerous and less disruptive for bowel function and lifestyle than surgically removing part of the colon (colectomy), a major abdominal procedure.
But large polyps can be difficult to remove during colonoscopy because:
For these reasons, some doctors may refer patients with large polyps for colectomy. “However, any complications can be quite serious and may lead to a temporary colostomy,” says Dr. Church.
A newer option — for a small group of patients with large colorectal polyps — is endoscopic submucosal dissection (ESD).
“ESD is an advanced way of doing surgery through the colonoscope, using tiny knives to cut away the polyp and save the colon,” says Dr. Church.
The risk of perforating the bowel is higher with ESD than with polypectomy, he notes. But ESD does have the potential to spare patients from colectomy.
If you have a large, benign colorectal polyp and surgery was recommended, remember that it may not be your only option.
“Removing polyps gets trickier as they get bigger. But be sure to get a second opinion from a doctor experienced in advanced polypectomy techniques,” says Dr. Church. “Some of us may be more comfortable removing large polyps than others.”
Meanwhile, he adds, doctors will continue to push the boundaries and find better ways to remove the polyps that cause colorectal cancer.