Polyp

What is a Polyp?

A polyp is a growth that forms inside an organ or within a body cavity. A significant portion of polyps are benign, therefore they do not pose a cancer risk. However, some polyps are pre-cancerous and can transform into cancer. Lastly, polyps can also be malignant, showing tendencies to spread.

Polyp Diagnosis Criteria

When symptoms of a polyp lead to a doctor's visit, various methods such as gastroscopy, colonoscopy, or hysteroscopy are used for diagnosis. Different diagnostic methods are used depending on the location of the polyp.

Causes of Polyps

Polyps are formed due to abnormal cell growth, but generally, there is no clear cause for polyps.

Symptoms of Polyps

The symptoms caused by polyps vary depending on their location. Some polyps may not show clear symptoms. Symptoms exhibited by polyps depending on their location include:

• Ear polyps may cause symptoms such as hearing loss and bloody discharge from the ear.
  
  
• Symptoms of cervical polyps usually include bleeding or unusual discharge, although cervical polyps often do not show any symptoms.
  
  
• Colorectal polyps may cause abdominal pain, diarrhea, constipation, or blood in the stool.
  
  
• Nasal polyps may cause symptoms such as headaches, loss of smell, nasal pain, and a persistent cold.
  
  
• Uterine polyps cause irregular menstrual bleeding and infertility.
  
  
• People with stomach polyps may experience pain, sensitivity, nausea, vomiting, or bleeding.
  
  
• Symptoms caused by throat polyps include a hoarse voice developing over days to weeks.
  
  
• Symptoms of bladder polyps include blood in the urine or painful and frequent urination.
  
  
• Symptoms of endometrial polyps include heavy menstrual periods, difficulty getting pregnant, and bleeding between periods or after intercourse.
  
  
• Gallbladder polyps typically show no symptoms.
  
  
• Skin polyps, also called fibroepithelial polyps, do not cause any symptoms.

Polyp Treatment Methods

In treating polyps, methods are followed both to alleviate symptoms and to remove the problem. Additionally, polyps may need to be removed or monitored to reduce cancer risk. The following points are considered when determining treatment:

• Type of polyp
• Size of the polyps
• Number of polyps
• Whether the polyps are cancerous

Polyp Surgery

Polyp surgeries, known as polypectomies, are surgical procedures performed to remove polyps that develop inside organs or within body cavities. It is a method applicable to both malignant and benign polyps.

Reasons for performing polypectomy surgeries include:

• Causing symptoms or complications
• Needing to be examined in a laboratory
• Suspected to be malignant or precancerous

Conditions Treated with Polypectomy

Polypectomy surgery is used for the removal and examination of many polyps. These purposes include:

• Colon polyps
• Uterine polyps
• Stomach polyps
• Gallbladder polyps
• Colorectal cancer
• Cervical cancer
• Stomach cancer
• Gallbladder cancer

Before Polypectomy

Typically, no special preparation is required before polypectomy surgeries. However, if a colonoscopy is performed for searching or removing colon polyps, the intestines must be clean.

Doctors recommend medications to help cleanse the intestines before the procedure. The preparation for a colonoscopy can take up to 24 hours to complete.

Pain relief options should be discussed during surgery. In addition, patients are given sedatives or anesthesia intravenously (IV) to prepare for the procedure. Also, prescriptions for any necessary medications before or after the procedure are issued.

What Happens During Simple Polypectomy Surgeries?

Simple polypectomy is an endoscopic procedure. Thus, it is performed using a type of endoscope, a long flexible tube with a lighted camera on it, which enters different regions of the body. Different variations are used to access different areas. For example, colonoscopy is used to examine the large intestine, while hysteroscopy is used for the uterus.

Experts pass the endoscope through the anus, cervix, or throat to reach the polyp. Subsequently, the camera images are displayed on a screen. Doctors use these images to manage the polyp's location and perform necessary procedures. Additionally, carbon dioxide gas may also be pumped through the endoscope to inflate the organ for better visibility.

Small tools are placed inside the endoscope to remove the polyp. Surgical forceps or special instruments are used to grasp the polyp or to scrape it. Polyps can be frozen or heated with special tools to facilitate their stationary removal. Different endoscopy tools are used to remove different types of polyps in different areas.

During polypectomy surgeries, the polyp is removed from its base or stem without cutting the surrounding tissue. Consequently, a small amount of polyp tissue may remain behind. This tissue is then burned off with an electrocauterization device. This process also helps to prevent bleeding.

Complex Polyp Resection Procedure

Some polyps cannot be removed with simple polypectomy due to various reasons, including being too flat or large to be grasped with forceps or clamps. Additionally, remnants of cancer require a different approach to remove the polyp and all the cancerous tissue. Due to these differences, polyp resection is performed. Alternative approaches in polyp resection include:

Laparoscopic surgery

Laparoscopic surgery, performed with incisions called keyhole cuts, is one of the minimal invasive surgery methods. At least two cuts are made in the abdominal area to reach the polyps. One of these incisions is made for the laparoscope, while the other is for surgical tools.

Endoscopic mucosal resection

Endoscopic submucosal dissection

Especially used for removing large or suspected cancerous polyps, endoscopic submucosal dissection involves cutting the deep submucosal layer underneath the polyp using an electrosurgical cutting device. This method allows for the removal of larger polyps without leaving any tissue behind.

Benefits of Polyp Surgery

While a significant portion of polyps do not cause any problems and do not turn into cancer, early intervention on polyps suspected of turning into cancer is extremely important. Therefore, removing and analyzing polyps is the only way to be sure whether cancer is present.

Additionally, through surgery, doctors can gain more information about the type of the polyp and its potential for change. With this information, future care for patients can be easily planned.

Complications of Polyp Surgery

Complications after polyp surgery are rare but may include:

• Bleeding
• Infection
• A hole or tear causing leakage in the organ
• Transmural burn from the electrocauterization device

Life After Polyp Surgery

After polypectomy surgeries, patients are typically discharged within a short time. However, they need someone's help to get home because they may experience difficulties focusing due to the effects of anesthesia.

After the surgery, gas may remain in the organ due to the procedure, which can cause mild discomfort for patients. It is recommended that affected patients consume easily digestible foods for a few days after the surgery.

Types of Polyps

A significant portion of polyps do not turn into cancer. However, certain types of polyps have a much higher likelihood of becoming cancerous. Polyps are classified according to the type of cells they appear in. These types include:

Adenomatous Polyps

About 70% of the polyps seen in the body are adenomatous polyps. Although only a small percentage of these polyps become cancerous, nearly all malignant polyps start as adenomatous. Since the transformation of these polyps into cancer usually takes many years, regular screening can eliminate the risk of cancer.

Hyperplastic Polyps

Hyperplastic polyps, which show an extremely low likelihood of turning into cancer, are a common type of polyp. They are serrated and small in size. These polyps can potentially turn into cancer depending on their size and location.

Varieties of Polyps

Polyps vary according to the area they are located in. Types of polyps include:

Endometrial Polyp

Endometrial polyps, seen on the inner lining of the uterus, are relatively rare in young women and their frequency decreases after menopause. Endometrial polyps are non-malignant growths on the uterine muscle walls that can be a sign of fibroids.

Also known as uterine polyps, endometrial polyps are growths that extend into the interior of the uterus from its inner wall. Generally benign, endometrial polyps need to be examined as they can be cancerous or precancerous. Multiple polyps can be seen in the uterus, and they usually remain within the uterus.

Gallbladder Polyps

Abnormal tissue growths protruding from the inner mucosal layer of the gallbladder are called gallbladder polyps. Generally harmless, gallbladder polyps can also be a sign of another disease.

About 5% of gallbladder polyps can turn into cancer and may cause complications such as inflammation. Gallbladder polyps themselves are categorized into various types, including pseudopolyps, inflammatory polyps, adenomyomatosis, adenomas, and malignant polyps.

Vocal Cord Polyps

Also known as vocal cord lesions, vocal cord polyps are polyps that form on the vocal cords. They can be benign or malignant. Polyps on the vocal cords can cause changes in voice and may make speaking difficult.

Vocal cord polyps, resulting from repeated, excessive, and incorrect use of the voice, can also occur from a single instance of excessive shouting. They usually develop on one vocal cord, but rubbing of the polyp against the other vocal cord can cause an additional polyp to form.

Intestinal Polyps

Also known as colon polyps, intestinal polyps are growths on the inner linings of the large intestine. Extremely common, colon polyps are usually harmless. However, some types can cause cancer if not treated.

Although not all polyps cause cancer, nearly all colorectal cancers start from polyps. Colon polyps are divided into three main groups: adenomatous polyps, serrated polyps, hamartomas, and inflammatory polyps.