What is the treatment for rectal polyps

Rectal polyps are a type of benign rectal tumor, which mainly occur on the rectal mucosa. Rectal polyps are not uncommon in clinical practice and will not cause any major problems as long as they are treated in time. The main treatment for rectal polyps is resection, so surgical treatment is more traditional.

1. Electrocautery

If the polyp is located higher and cannot be removed through the anus, the polyp is exposed through a proctoscopy, sigmoidoscope or fiber colonoscope. For pedunculated polyps, a snare is used to wrap around the pedicle and electrocautery is performed to remove it. Electrocautery of sessile polyps is unsafe.

2. Transanal resection

Suitable for polyps in the lower rectum. It is performed under sacral anesthesia. After dilating the anus, the polyp is pulled out with tissue forceps. For benign pedunculated polyps, the pedicle is ligated and the polyp is removed. For broad-based polyps, part of the mucosa around the polyp should be removed and the wound should be sutured. In the case of villous adenoma, the tangent line should be at least 1 cm away from the edge of the adenoma visible to the naked eye.

3. Anoscopy-assisted microsurgical resection

Indicated for local excision of adenomas and early rectal cancer in the upper rectum. After anesthesia, an anoscope for microsurgery is inserted through the anus, the surgical field is magnified through the TV screen, and the polyp is removed under the microscope. Compared with electrocautery resection, the advantage is that the wound can be sutured after resection, avoiding postoperative complications such as bleeding and perforation.

4. Laparotomy

It is suitable for cancerous polyps that are difficult to completely remove under endoscopy, are located higher, or are broad-based polyps with a diameter greater than 2 cm. During laparotomy and local resection, if the adenoma is found to have become cancerous, it should be treated according to the principles of rectal cancer surgery. Familial polyposis will develop into cancer sooner or later and must undergo radical surgery. The decision whether to retain the rectum should be made based on the distribution of rectal polyps. Rectal resection or rectal mucosal stripping, ileal J-pouch-anal anastomosis through the rectal muscle sheath, etc. can be performed.

5. Others

The main treatment for inflammatory polyps is the primary intestinal disease; for hyperplastic polyps, the symptoms are not obvious and no special treatment is required.