Surgery to remove a polyp of the sigmoid colon. Symptoms of sigmoid colon polyps, causes, treatment regimen and diagnostic methods

Making a diagnosis like a polyp sigmoid colon, indicates the development of a pathological process in the human body, which contributes to the development of this neoplasm. Can surgery completely eliminate polyposis, what measures will delay the onset of relapse, and what is the peculiarity of the postoperative period? Let's figure it out.

Definition of pathology

A polyp is a benign tumor-like formation that affects the mucous membrane of the descending part of the sigmoid colon. It is located on the left side of the peritoneum and looks like the Latin letter "S". In this section of the large intestine, the final assimilation of nutrients and the final formation of feces takes place.

A polyp in the sigmoid colon develops from the glandular fibers of the mucous membrane and grows into the intestinal lumen, representing a precancer. At the initial stages of the formation of a polyp in this organ, the patient experiences symptoms similar to indigestion. But, as education increases, the patient begins to be disturbed by pain, which contributes to seeking medical help.

Etiology of neoplasms

Scientists have not yet come to a consensus about the primary cause of the development of a tumor of the sigmoid colon. But most doctors believe that the following factors can provoke the disease:

• Diseases of the large intestine of a chronic type (for example, chronic colitis, Crohn's disease, ulcerative colitis, diverticulosis, and others);
  low physical activity;
• Dysbacteriosis;
• Nutritional errors. For example, a reduced amount of fiber consumed, which contributes to a decrease in intestinal motility;
• Hereditary factors predisposing to the development of polyps;
• Gender, since it has been established that the fair sex suffers from this disease 3-4 times less often than men.
• Clinical manifestations

Polyps of the sigmoid colon, as a rule, occur in the presence of poor symptoms. That is why the disease is detected quite by accident during a colonoscopy or barium enema for a third-party disease. Primary symptoms make themselves felt during the growth of the tumor and its achievement large sizes(more than three centimeters).

They are characterized by soreness in the lower abdomen, aggravated by an attempt to empty the bowels, as well as constipation, diarrhea and false urge to defecate, and bloody mucous discharge from the rectum.

In the later stages of tumor development, symptoms of chronic and acute intestinal obstruction may occur.

Diagnostic measures

For diagnostic examinations, it is recommended to contact a gastroenterologist, who is obliged to prevent the occurrence of bowel cancer by identifying polyps in time. To implement these measures, the patient should be referred for the following examinations:

• Analysis of fecal masses for the detection of occult blood particles is the main primary study, but its negative result does not guarantee the complete absence of polyps;
• Digital examination of the lower part of the rectum;
• Irrigoscopy - examination of the intestine with the use of a contrast agent;
• Colonoscopy is the most effective endoscopic method for detecting polyps. Colonoscopy allows you to examine the entire large intestine from the inside using a plastic tube - a colonoscope;
• Sigmoidoscopy is an examination of the lower parts of the large intestine - the rectum and the initial section of the sigmoid - thanks to a flexible tube with LED light.

Features of treatment

It should be noted that none of the methods of conservative therapy is effective if the patient has polyps in the sigmoid colon. The only possible treatment in this situation is surgery to remove the neoplasm. It is possible thanks to many techniques, but the choice of a particular one depends on the condition of the tumor, its size and quantity. The following methods are traditionally used:

• Endoscopic intervention carried out through the rectum, into which an endoscope with a loop electrode is inserted. This loop is put on the polyp, clasping the leg, and cuts it off. This method is suitable for single formations of a small size, since multiple ones have to be excised in parts. This type of surgery is well tolerated by the patient and does not require a long period of rehabilitation.
• Laparoscopic resection of the sigmoid colon is used when diffuse polyposis occurs. During the operation, the area of ​​the sigmoid colon affected by polyps is removed. A variation of such an intervention on the sigmoid colon is obstructive resection, which is performed with frequent degeneration of the tumor into a malignant formation. In this case, the lumen of the distal segment is displayed on the anterior abdominal wall and is called a colostomy.
• Electrocoagulation involves the removal of polyps with a current of constant or variable frequency.

In the future, it is possible to eliminate the colostomy with the subsequent restoration of the natural anus.

rehabilitation period

The operation on the sigmoid colon involves further monitoring of the patient and it is important to understand that this is not the end of his treatment. During this period, the following actions are carried out:

• Washing the intestine three times a day through special tubes with antiseptic solutions, which are removed already 7-10 days after the operation;
• Removal of a polyp of the sigmoid colon involves taking antibacterial drugs for five days;
• Means are prescribed to promote stool retention;
• A special diet is prescribed, which implies the intake of exclusively liquid foods;
• After 4-7 months of a favorable course of the postoperative period, it is possible to restore the integrity of the intestine and eliminate the colostomy.

To completely exclude the occurrence of a recurrence of the disease after surgery to remove polyps of the sigmoid colon, the patient should be under regular medical supervision. Therefore, dispensary registration is carried out 5-6 months after resection of the sigmoid colon and then once a year. The timing of dynamic control depends on the effectiveness of the treatment.

Diet food

The diet for sigmoid colon cancer after surgery implies complete mechanical sparing of the intestinal mucosa. For this, the doctor prescribes a dietary table No. 4 according to M.I. Pevzner, which must be observed within a month, and over the next 30 days, restrictions on spicy, pickled, salty, sour and fried foods come into force.

A month later, a control endoscopic examination is performed to control therapy and the question is raised about canceling or continuing the diet after removal of the polyp.

Things to Remember

Treatment of a sigmoid colon polyp largely depends on the time interval from the discovery of symptoms to seeking medical help. Do not ignore a visit to the hospital, especially since the development of polyps cannot be done without a colonoscopy.

It is important to regularly attend preventive examinations and follow the doctor's prescriptions during the rehabilitation period, namely:

• Leave bad habits;
• Follow a diet after surgery;
• Avoid heavy lifting and hypothermia;
• Maintain a sleep and rest schedule.

Polyp of the sigmoid colon is a common ailment among patients of different ages and gender. It is important to competently approach the issue of treatment and follow all the instructions of the postoperative period.

- These are benign tumor-like formations, which are abnormal growths of tissues in the area of ​​​​the mucous membrane of the sigmoid colon. Most often they are asymptomatic. Can be manifested by abdominal pain, stool disorders and pathological impurities in the feces. Large polyps can cause intestinal obstruction with the development of intestinal obstruction. There is a risk of malignancy. They are diagnosed on the basis of digital examination, irrigoscopy, rectosigmoscopy and biopsy. Surgical treatment - surgical excision, endoscopic polypectomy or resection of the affected area of ​​the intestine.

ICD-10

D12.5 sigmoid colon

General information

A polyp of the sigmoid colon is an outgrowth of the intestinal wall, originating from its mucous membrane. It is a widespread pathology. According to researchers, polyps of the sigmoid colon are detected in 20% of the population, while in the small intestine these formations are rare, and the left half of the large intestine, which includes the sigmoid colon, is affected more often than the right one. There is a slight predominance of male patients. Polyps of the sigmoid colon can vary in size and structure, have a wide base or a narrow stalk, be single or multiple, have a high or low tendency to malignancy. The most dangerous in terms of degeneration into a malignant tumor are villous polyps. Treatment is carried out by specialists in the field of clinical proctology and oncology.

The reasons

Classification

Taking into account the number, single and multiple polyps of the sigmoid colon are distinguished, taking into account localization - located in groups or diffusely distributed throughout the intestine. Polyps may have a narrow stalk or a broad base ("sessile" polyps). The size of the formations ranges from 1-2 millimeters to 5 or more centimeters. Taking into account the peculiarities of the histological structure, the following types of polyps of the sigmoid colon are distinguished.

• glandular (adenomatous). They make up more than 50% of the total number of such formations. They usually do not exceed 2-3 cm in size. They are pinkish or reddish nodes, along appearance adenoma-like.
• Glandular villous. They are a transitional form between adenomatous and villous polyps of the sigmoid colon.
• villous. They are lobed formations covered with villi. They have branched capillary networks, often bleed. They may ulcerate. More often than other types of polyps of the sigmoid colon are transformed into malignant tumors. The probability of malignancy increases sharply with an increase in the size of the formations.
• Hyperplastic. They are growths of the epithelium up to 0.5 cm in size. They are often detected against the background of chronic inflammatory processes. They can transform into other types of polyps.

In a separate group, the so-called juvenile polyps of the sigmoid colon are distinguished - formations detected in childhood and adolescence. The size of such polyps can exceed 5 cm, but there are no signs of cellular atypia and growths of the glandular epithelium. Malignancy is extremely rare.

Symptoms of polyps

In most cases, sigmoid colon polyps are asymptomatic. Some patients have stool disorders (diarrhea, diarrhea) and pain in the left side of the abdomen. When bleeding from a damaged polyp, blood impurities may appear in the feces. Villous polyps can produce large amounts of mucus, which is also found in the stool as impurities. With repeated bleeding from large polyps (more often multiple), anemia sometimes develops. With prolonged release of a large amount of mucus, disorders of water-salt metabolism may occur.

Large polyps of the sigmoid colon can block the intestinal lumen and cause intestinal obstruction. This complication is manifested by cramping pains in the left half of the abdomen and the left iliac region, bloating and asymmetry of the abdomen, difficulty in passing gases and feces, nausea and vomiting. In the absence of timely treatment, the condition of a patient with a sigmoid colon polyp worsens, intestinal paresis, dehydration, hypovolemia and oliguria develop. Emergency surgery is needed.

Diagnostics

The diagnosis of a polyp of the sigmoid colon is established by a specialist proctologist, taking into account the patient's complaints and data from additional studies. On the initial stage perform palpation of the abdomen and digital rectal examination. Palpation may reveal pain in the left side of the abdomen. With a low location of the polyp of the sigmoid colon, the formation can sometimes be felt during the rectal examination. The result of a stool test for occult blood in villous polyps is often positive. With solitary adenomatous polyps, the test may be negative.

During barium enema, it is usually possible to detect polyps of the sigmoid colon larger than 1 cm. To identify smaller formations, endoscopic examination is necessary - sigmoidoscopy or colonoscopy. Colonoscopy is prescribed for suspected presence of polyps and other pathological processes not only in the sigmoid colon, but also in the overlying sections of the intestine. Endoscopic techniques allow you to visually assess the number, location, size and type of sigmoid colon polyps. During the study, the doctor takes tissue samples for subsequent study of the histological structure of the formations. In some cases, endoscopy is therapeutic and diagnostic in nature.

Treatment of sigmoid colon polyps

Surgical treatment. Depending on the diameter, number, type and cause of the appearance of the nodes, endoscopic polypectomy, removal of the sigmoid colon polyp by laparotomy or resection of the affected intestine with the formation of a direct anastomosis between the remaining areas is performed. The operation is carried out in a planned manner after an appropriate examination. Endoscopic polypectomy can be performed on an outpatient basis or in a hospital, traditional surgical interventions are performed only in a specialized surgical department.

Endoscopic removal of polyps of the sigmoid colon is possible in the presence of small formations that do not show signs of malignancy. The polyp together with the leg is excised using a special loop, which simultaneously acts as a tool for electrocoagulation of bleeding vessels. Large polyps of the sigmoid colon are removed in parts. Due to technical difficulties, endoscopic polypectomy for large lesions carries a higher level of risk to the patient. Complications are possible in the form of a gas explosion in the intestinal lumen, bleeding and perforation of the colon during surgery.

Given these complications, traditional surgical techniques are usually used to remove large sigmoid colon polyps. The operation is performed under general anesthesia. The surgeon opens the intestinal wall, resects the polyp along with the stalk, and then sutures the intestine and sutures the anterior abdominal wall. With multiple and complicated polyps of the sigmoid colon, resection of the intestine may be required, which is also performed under general anesthesia. After abdominal operations, patients are prescribed bed rest, a special diet, painkillers and antibiotic therapy.

All removed polyps of the sigmoid colon are sent for histological examination. If signs of malignancy are found, further examination of the patient is indicated to determine the prevalence of the oncological process in the intestine, to identify regional and distant metastases. After the examination, an extended surgical intervention is performed.

Forecast and prevention

With polyps of the sigmoid colon without signs of malignancy, the prognosis is favorable. Patients are followed up regularly after surgery. With adenomatous polyps, endoscopic examination is performed first every six months, then annually. For patients with villous polyps of the sigmoid colon, sigmoidoscopy or colonoscopy is performed quarterly during the first year, and annually thereafter.

Polyps of the sigmoid colon are called benign neoplasms, consisting of tissues of the glandular epithelium lining the walls of the intestine and growing inside the intestinal lumen.

Mushroom-shaped, spherical and grape-shaped, they are attached to the walls of the affected organ with a narrow stalk or wide base and can eventually degenerate into malignant tumors.

Kinds

Polyps localized in the sigmoid colon are:

• Hyperplastic. Neoplasms of this type, not exceeding five millimeters in diameter, are most often found in the intestine. The light color of hyperplastic polyps, resembling flat spherical plaques, makes them clearly visible against the background of a darker mucosa. Despite the fact that hyperplastic polyps become malignant extremely rarely (despite multiple manifestations), the course of the tumor process should be under the control of a qualified specialist.
• Adenomatous- extremely dangerous neoplasms that have a high ability for malignant degeneration during the first ten years (that is why doctors consider them a precancerous condition). The size of adenomatous polyps ranges from one to five centimeters. Adenomatous polyps, in turn, are divided into tubular neoplasms, villous tumors and tubular-villous polyps. Not giving the patient any problems in the initial stages of their development, all of them can eventually reach large sizes and cause acute intestinal obstruction, and easily injured villous tumors can be a source of constant bleeding.
• diffuse due to the presence of hereditary diseases represented by Peutz-Jeghers, Cowden, Lynch, Turcot syndromes, as well as juvenile and familial adenomatous polyposis. In the intestines of even very young patients who have inherited this disease, an incredible number of rapidly developing neoplasms, numbering in the hundreds and even thousands, are found.

Causes of the disease

Polyps of the sigmoid colon belong to the category of polyetiological diseases that develop under the influence of several factors at once. Most often, their appearance is due to:

• The presence of chronic intestinal diseases (, and nonspecific).
• leading to an imbalance in the intestinal microflora.
• Intervention of a hereditary factor: according to medical statistics, 35% of patients diagnosed with intestinal polyposis have close relatives suffering from a similar pathology.
• Belonging to the male sex: statistics support the fact that polyps in the sigmoid colon are found in the stronger sex three times more often than in women.
• Sedentary lifestyle and lack of physical activity. Due to the fault of this factor, obesity develops and a significant deterioration in intestinal motility is fraught with the occurrence of frequent constipation and inflammatory processes in the tissues of the mucous membrane of the sigmoid colon.
• An unbalanced diet containing an insufficient amount of vegetable fiber, as a result of which intestinal motility decreases and the time of exposure of carcinogenic substances contained in stagnant feces to the tissue of the mucous membrane of the sigmoid colon increases. The amount of carcinogens, which are bile acids and substances derived from them, increases significantly in the body of people who eat too many fatty foods, meat and confectionery, for the digestion of which a significant amount of bile is required.

Clinical symptoms of polyps in the sigmoid colon

The symptomatology, which directly indicates the presence of polyps in the sigmoid colon (this is especially true for single neoplasms that rarely cause discomfort), is so meager that a sick person may not even be aware of his illness for a long time.

The virtual absence of external manifestations is the reason that the disease is most often detected during an examination undertaken for a completely different ailment.

The presence of multiple neoplasms can be a source of significant discomfort. First clinical symptoms appear after the polyp has reached a significant (more than 3 cm) size.

Running polyposis of the sigmoid colon is accompanied by the following manifestations:

• Each attempt by the patient to sit down or perform a sudden movement may be accompanied by severe itching and sharp pain in the lower abdomen.
• In the presence of villous polyps, penetrated by many blood vessels and having a tendency to be damaged even with slight contact with fecal masses passing through the intestine affected by them, the patient notices the appearance of blood threads or blood clots in his own stools. With severe ulceration of villous tumors during the act of defecation, significant bleeding may develop. In rare cases, when blood loss is up to one and a half liters, it can even threaten the life of a sick person.
• Glandular polyps provoke the appearance of a large amount of mucus in the feces. Sometimes the stool may consist of only mucus.
• Because the certain types polyposis are accompanied copious excretion fluid into the lumen of the sigmoid colon, the clinical course of the disease is characterized by a constant alternation of constipation and bouts of diarrhea. Symptoms of intestinal dyspepsia are often supplemented by false urges to defecate.
• A sick person notes constant belching, heartburn, bloating and increased flatulence.
• Large neoplasms that have reached an impressive size can fall out of the body of a sick person through the anus.
• The last stages of polyposis are accompanied by a significant deterioration in the patient's condition: he develops acute, increased fatigue and extreme muscle weakness, often severe headaches and fever body.

Diagnostics

In the event of a complete absence clinical manifestations polyposis a person can live to an advanced age without even knowing about the presence. Most likely, benign neoplasms will never be detected in him.

If the patient has any disorders on the part of proctology, he will definitely be prescribed a diagnostic examination, which consists of a number of laboratory and instrumental studies.

The first step in the diagnosis of sigmoid colon polyps is a physical examination of the patient, consisting of:

• Collecting an anamnesis, during which the doctor will ask the patient about the presence of complaints, previous diseases, his lifestyle and diet. The patient will definitely be asked about the presence of close relatives who have ever had bowel disease.
• A digital examination of the lower part of the rectum, which allows to identify neoplasms present in it or to make sure that they are absent.

Instrumental diagnostics is carried out by methods:

• Colonoscopy- endoscopic examination carried out using a colonoscope. This instrument is a flexible and very thin metal tube equipped with a light and a fiber optic video camera that allows you to display an image on a monitor. The length of the device, introduced into the patient's body through the anus, allows visual inspection of all parts of the intestine - from the anal canal to the caecum. To improve the quality of the examination and straighten the folds of the intestine, using a special tube, the doctor pumps air into the cavity of the intestine being examined. Having found any neoplasm, the specialist takes a biopsy - pinches off a tiny piece of tissue from it using biopsy forceps. The resulting samples are immediately sent to the laboratory to exclude the presence of cancer cells in them. Small benign neoplasms can be removed already during a diagnostic study, in which case colonoscopy simultaneously plays the role of an operative intervention. Given the high pain of the procedure, the patient must be anesthetized.
• A less informative method is the almost identical sigmoidoscopy procedure performed using a sigmoidoscope (this device also has a video camera, a lighting device and forceps for biopsy). allows you to examine a limited area of ​​​​the intestine, including the entire rectum and the initial section of the sigmoid.
• To examine the mucous membranes of the rectum and sigmoid colon, a sigmoidoscopy procedure may be prescribed., carried out by carefully introducing the sigmoscope into the patient's intestines (through the anus, at a distance not exceeding 60 cm). With the help of this study, which is considered more gentle than colonoscopy, it is possible to detect almost 90% of the pathological processes occurring in the cavity of the rectum and sigmoid colon. The main disadvantage of this method is the inability to detect neoplasms that do not exceed one centimeter in diameter.
• Irrigoscopy- x-ray examination, which consists in the introduction of a radiopaque substance - barium sulfate into the cavity of the large intestine and the performance of x-rays. The method of double contrasting, which involves the simultaneous introduction of a barium suspension and the pumping of air into the intestinal lumen, straightening the mucosal folds, can significantly improve the quality of the obtained radiographs. Neoplasms located on the walls of the intestine, on x-rays look like defects in its filling.

The analysis of feces for occult blood is an indirect confirmation of the presence of polyps in the patient's body, so it must be included in the diagnostic examination program.

Treatment of polyps in the sigmoid colon

Since drug treatment of sigmoid colon polyposis does not give any results, it is possible to get rid of neoplasms in the intestines only through them.

Modern surgeons do this by:

• Colonoscopic or sigmoidoscopy polypectomy followed by electrocoagulation of the bed;
• transanal excision;
• Endoscopic removal;
• Resection of a section of the sigmoid colon;
• Radical removal.

Polypectomy

The essence of this technique is as follows: a loop electrode is brought to the detected neoplasm, which is attached to the intestinal wall with the help of a thin leg, through a special channel of the operating endoscope.

By tightly clasping and tightening the loop on the leg of the polyp, they achieve a complete cessation of blood flow, after which a high-frequency current is passed through the electrode.

A few seconds of exposure is usually enough to cut off the head of the polyp and achieve charring of its legs. The body of the removed polyp is immediately removed from the patient's body by suction to the endoscope or with the help of grab forceps, and the bed of the removed neoplasm is additionally cauterized.

This is done in relation to neoplasms of small sizes on a thin stalk. If the leg of the polyp turned out to be quite thick, the surgeon cuts off the polyp gradually, changing the tactics of cutting and coagulation modes.

Diet after removal of education

After the removal of polyps of the sigmoid colon, the key to a quick and successful recovery of the patient, excluding the possibility of relapse, is a sparing diet. Its main purpose is to prevent the occurrence of constipation and conditions that provoke irritation of the intestinal walls.

How to organize the nutrition of a patient who has undergone a polypectomy?

• In his daily diet should be at least six meals, eaten at regular intervals. The volume of one serving should be such that the product used fits in a handful.
• All dishes are prepared by boiling, stewing and steaming. Fried foods are strictly prohibited.
• The amount of table salt added to dishes is significantly limited.
• It is unacceptable to consume excessively hot and too cold food and drinks.
• The use of spicy, sour and salty foods is strictly prohibited.
• Solid food should be passed through a meat grinder or fine grater.
• Any cereal should be wiped through a sieve or chopped in a blender.

A person suffering from polyposis is strictly prohibited from using:

• Fatty varieties of fish, poultry and meat.
• Any cabbage.
• Radishes and radishes.
• Canned food and marinades.
• Purchased sauces (especially ketchup and mayonnaise).
• Strong coffee.

Strict adherence to the diet is recommended to the patient during the first month after surgery. A positive result of the control endoscopic examination is the basis for some mitigation of the requirements for the nutrition of the operated person.

Consequences of the disease

Polyps of the sigmoid colon are capable of:

• Reborn into .
• Become the culprits of anorectal bleeding due to traumatization of neoplasms (especially villous tumors).
• Provoke acute intestinal obstruction due to blockage of the lumen of the affected intestine by an overgrown neoplasm.
• Lead to the development of an acute - dangerous condition characterized by inflammation of the intestinal wall. In the case of rapid progression, enterocolitis can result in the death of a sick person.
• Cause anemia due to constant bleeding.

The operation of polypectomy with electrocoagulation of the bed of the removed neoplasm can lead to perforation of the intestinal wall. Despite the fact that the intestines of a patient who has undergone special preoperative preparation contain only gases, if this complication occurs, a set of measures is taken to prevent peritonitis - inflammation of the peritoneum.

Prevention

No one is immune from the occurrence of polyps in the sigmoid colon, however, the implementation of a number of simple rules can reduce this risk by several times:

• When symptoms of polyposis appear (the admixture of mucus and blood in the stool should be especially alert), each person should immediately consult a proctologist and undergo a diagnostic examination.
• In case of detection of benign neoplasms, it is necessary to go through the procedure for their removal as soon as possible.
• A complete rejection of alcohol will also reduce the content of carcinogens that enter the human body and contribute to the development of polyposis.
• Of great importance in the prevention of polyposis is proper nutrition, replete with fresh herbs, vegetables and fruits containing a large amount of vegetable fiber. Category useful products include lean fish and meats, whole grain breads, and vegetable oils. People seeking to prevent the development of polyposis should once and for all exclude spicy, smoked, fatty and fried foods, dishes from their diet. fast food(especially fast food), canned food and pickles, coffee and carbonated drinks, fresh pastries and high-calorie confectionery.
• The use of a large (up to 1.5 l) amount of drinking water, green tea and juices, which contributes to the normalization of digestion, is also a good prevention of the occurrence of benign neoplasms.
• Everyone should strive to normalize weight and prevent obesity.

Indications for polypectomy of the sigmoid colon - the presence of any polypous node larger than 5 mm in diameter, and the contraindications are as follows:

• infectious diseases;
• acute inflammatory processes;
• epilepsy;
• the presence of a pacemaker or cardiovascular insufficiency;
• diabetes;
• blood clotting disorder.

The decision on the advisability of operative measures is taken by the attending physician.

Preparation for the procedure for the removal of a polyp of the sigmoid colon

To prepare the patient for the removal of polyps in the sigmoid colon, the necessary tests are taken before the operation and examinations are carried out:

• general analysis of blood and urine;
• fluorography of the lungs;
• Ultrasound of organs abdominal cavity;
• fibroesophagogastroduadenoscopy (probe examination of the stomach and duodenum);
• colonoscopy (transanal revision of the intestine).

Probe removal of a polyp from the sigmoid colon requires careful preparation: the day before, you need to switch to a semi-liquid diet, and make cleansing enemas the night before and in the morning.

The process of the procedure

Removal of the polyp of the sigmoid colon is performed on the day of hospitalization. The intestinal mucosa does not have pain receptors. That is why general anesthesia is not performed, but due to discomfort when advancing the probe and removing the polyp of the sigmoid colon on a wide leg, local anesthesia is used. Local anesthetics are applied to the tip of the probe.

The duration of an endoscopic operation to remove a polyp in the sigmoid colon varies from 10 to 25 minutes, and its course and stages depend on the size and shape of the neoplasms:

• a colonoscope with the necessary set of instruments is inserted through the rectum;
• removal of a polyp on a thin base is performed by capturing the polyp with an electrocoagulation loop and subsequent cutting off by current;
• the creeping tumor is pulled back with forceps and either removed completely or excised with an electrocoagulator in parts;
• then the bed of the node is sealed with current.

Complications after surgery

With this minimally invasive method, complications are extremely rare. But in view of the surgical manipulation to remove polyps, certain consequences can still occur, for example:

• bleeding;
• perforation of the intestine during the operation;
• pain (in case of a large area of ​​mucosal burn).

Bleeding in the first two days due to insufficient coagulation. On the 5th-6th day - due to the rejection of the scab.

The likelihood of consequences is determined by the experience of the medical professional and the severity of the individual case.

The period of rehabilitation after removal of polyps in the sigmoid colon

The rehabilitation period after endoscopic polypectomy does not require special care for the patient's condition. When working with small growths, the patient is discharged from the hospital on the third day. If the situation is more complicated, then bed rest lasts 7-10 days.

• semi-liquid cereals, juices and water for the duration of your stay in the hospital;
• post-stationary diet, which eliminates constipation;
• restoration of the burn surface by taking vaseline (for large areas of intervention).

Prices and clinics

The cost of surgery to remove polyps of the sigmoid colon in hospitals and medical centers is determined by the qualifications of the staff and the cost of consumables.

Prices for the removal of a polyp of the sigmoid colon on a narrow and wide stalk in the best clinics in Moscow vary in a wide range and depend on the level of equipment, the qualifications of the doctor and the volume of surgical intervention.

On our portal you can get all the necessary information about hospitals, doctors and costs.

Even benign tumors can negatively affect the body. A polyp of the sigmoid colon occurs due to frequent damage to the mucous epithelium, when tissues are tightened, which causes them to grow. The disease is classified into types. Depending on this, a certain clinical picture is observed. Often the patient is unaware of the presence due to the absence of symptoms.

If the disease continues to progress without proper treatment, then the patient has complications. After the diagnosis, the doctor prescribes only surgical therapy. After that, the patient is provided with a therapeutic diet and a rehabilitation period after the operation.

Classification of types of polyp of the sigmoid colon

Benign tumors are divided by number and type. When diagnosing, there can be up to several of them. Polyps reach sizes of 5 cm. Then carry out the classification according to the type of disease. It depends on the location of the tumor.

Therefore, the following intestinal types of neoplasms are distinguished:

• adenomatous glandular polyp;
• hyperplastic tumor;
• diffuse neoplasms.

Adenomatous tumor in the sigmoid colon refers to a benign formation. However, due to provoking factors, the polyp turns into a malignant growth. The appearance of such a tumor reaches 5 cm in diameter. In addition, the adenomatous polyp is divided into subspecies. Therefore, tubular and villous are distinguished. However, the disease is able to absorb both subspecies.

Adenomatous polyposis in the sigmoid colon does not appear in a specific clinical picture. Signs begin to occur when the tumor grows in size. In addition, patients have problems during bowel movements. Digestive function begins to deteriorate, and the growth becomes malignant.

A hyperplastic polyp of the sigmoid colon often occurs in most patients. Growths for a long time are in a state of benign nature. This is a feature of hyperplastic polyposis. After diagnosing this type of disease, it is required to monitor the state of the body.

The attending physician will conduct preventive examinations to monitor the size of the neoplasms. To get rid of this type of polyp, you will need to follow the doctor's recommendations and perform a simple operation to remove the tumor.

Schematic photo of polyp removal

Diffuse growths occur due to a family predisposition. Often this is manifested during the formation of organs during the embryonic period. The appearance in adolescence of the first symptoms of the disease leads to the only treatment - the removal of tumors.

The diffuse appearance can be complicated by an abdominal cyst or cancer.

Why does the disease appear?

The development of polyposis is associated with the activity of disease cells. They are affected by a provoking factor and abnormal growth begins.

Sometimes primary diseases become the cause of development:

• chronic nature of inflammation of any intestine;
• dysbacteriosis;
• genetic predisposition;
• symptoms of hypodynamia;
• problems with bowel movements;
• diet low in fiber.

Accompanying symptoms of the disease

Any kind of polyposis in the initial stages does not appear. Therefore, the diagnosis is made by chance when an examination is carried out due to another disease. Symptoms of a polyp in the sigmoid colon appear after the growth of the tumor over 30 mm or the formations are multiple.

The first manifestation is fixed with the appearance of a sharp pain located in the lower abdomen. The symptom occurs with sudden movements or leaning forward. In addition, blood inclusions are located in the feces. Otherwise, there is mucus covering the feces. Along with this, there are false urges to empty the intestines and constipation. Additionally, there is diarrhea. The growths are able to fall out of the rectum due to their large size. The patient should be attentive to gases, belching and heartburn along with the first signs.

In the last stages, the disease manifests itself in a sluggish state of the patient. The patient complains of increased fatigue and headache with a slight increase in temperature.

How is the diagnosis made?

Diagnosis of polyposis is carried out by a proctologist or gastroenterologist. To determine the size and condition of the growths, the following studies are carried out:

• sigmoidoscopy - an endoscopic method, with the introduction into the rectum of a device for examining the intestine;
• irrigoscopy - an x-ray method using a contrast agent;
• colonoscopy - used to establish a diagnosis with the subsequent removal of one tumor.

When an irrigoscopy or colonoscopy is performed, the doctor is able to examine polyps in the sigmoid colon. In addition, a biopsy is done. This is required to determine the nature of the growth. Sometimes doctors more accurately determine the condition of the polyp using sigmoidoscopy.

Appointment of therapeutic measures

The polyp of the sigmoid colon is treated with a surgical technique. However, there are several basic operations to remove growths. For some, the doctor conducts additional diagnostics.

Operative methods of treatment

The polyp is able to be attached with a thin stem or a wide base. For treatment, you will need to hold a special tool with a loop at the end to the growth. This is the removal of the tumor with a polypectomy. In this case, the polyp is wrapped in a loop, and the formation is tightened. After that, a current of increased frequency is passed through the tool. Because of this effect, the leg and the polyp itself are separated, and the wound is cauterized.

Photo of a polyp in the intestine

If several formations are detected, the intervention is carried out in a couple of stages. Between operations make a break of 14 days.

Depending on the characteristics of the course of polyposis, the doctor is able to choose one of the following treatment methods:

• transanal removal - an operation to remove the tumor is performed by inserting a rectal speculum into the rectum, and then using special clamps for the formations, and the polyp is cut off (large growths are removed with a scalpel);
• endoscopic removal - the operation is performed using a rectoscope and is effective against any type and size of the tumor;
• resection - the operation is performed not only with the removal of the polyp, but also with the excision of a number of the affected tissue;
• radical operation - removal of the sigmoid colon and lymph nodes.

Methods for the treatment of polyposis with folk remedies

In addition to traditional treatment, in the initial stages, patients are able to cure polyps located in the sigmoid colon at home. In this disease, enemas with celandine juice are used. Otherwise treatment folk remedies involves the use of infusions from the golden mustache. For therapy against these neoplasms at home, it is recommended to consult with your doctor.

Therapeutic nutrition in the postoperative period

After one of the methods of surgical treatment, the patient is prescribed a certain diet. The purpose of adjusting the diet is to prevent the occurrence of constipation. In addition, during recovery, you should not eat foods that irritate the walls of the intestinal mucosa.

Because of what and how complications manifest themselves?

If polyps in the sigmoid colon are not treated and the symptoms of the disease are ignored, then patients develop further polyposis. This leads to unpleasant consequences for the entire body of the patient. In this case, a degeneration into a malignant formation occurs. The presence of polyps in the sigmoid colon causes frequent bleeding and anemia. Due to the constant growth of growths, the lumen decreases, and all food enters through the hole formed.

Photo of a polyp of the sigmoid colon

The development of the disease into enterocolitis is dangerous because inflammation of the intestinal wall occurs. In addition, Crohn's disease or diverticulosis develops. After removal of the growth by polypectomy, a complication occurs. The patient has perforation of the wall of the large intestine. After the operation to remove the polyp, the attending physician takes measures to prevent the inflammatory process.

Conclusion

When a polyp of the sigmoid colon appears, the disease can proceed for a long time before symptoms appear. Signs differ from the type of polyposis. Therefore, common symptoms are indigestion with constipation or diarrhea. A neglected disease is treated by removing the growth.

Sometimes it is required to resect the polyp and part of the sigmoid colon, where the lesion has begun to spread. In addition, patients experience complications associated with the digestive system.

The information on our website is provided by qualified doctors and is for informational purposes only. Do not self-medicate! Be sure to contact a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and conducts treatment. Expert of the group on the study of inflammatory diseases. Author of more than 300 scientific papers.