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December 25, 2016 00:09

Proctopolypus

colon polyps - benign epithelial tumors.They account for about 92% of all benign intestinal formations.

According to clinical classification of polyps are divided into single, multiple (group and scattered in various departments) and diffuse polyposis of the colon.Polyposis is characterized by bulky disease may be inherited, t. E. Is a genetically determined disease, and his description of the term "diffuse familial polyposis."

sizes of single and group polyps ranging from millet grain to the value of the walnut.Polyps may have a leg, sometimes reaching 1.5-2 cm, or placed on a broad basis.In diffuse polyposis, they densely cover the entire mucosa of the rectum and colon.According to their histological structure of the polyps are divided into adenomatous, villous and mixed (adenomatous, villous).

Symptoms of polyps

rectum Most colon polyps are asymptomatic and are accidental finding on endoscopy carried out over any other diseases or for prophylactic examinations of the colon.However, as the siz

e of the polyps, ulceration of the surface may appear, and then to progress such clinical symptoms of colon polyps, a nagging pain in the lower abdomen or lumbosacral region, abnormal discharge from the rectum.For large villous tumors are characterized by metabolic disturbances (changes in water and electrolyte balance, a significant loss of protein).Anemia may occur.

Diagnosis colorectal polyps

Between the appearance of clinical symptoms described above, all of the methods used colorectal examinations, ranging from digital examination and ending with colonoscopy.Detection of polyps at an early (asymptomatic) stage is possible with preventive examinations of persons older than 40 years, which, nb According to VDFedorov and V. Dultseva (1984), will allow to diagnose about 50% of all benign tumors.Since 50 to 70% of tumors located in the left parts of the colon, for the preventive screening may serve sigmoidoscopy.At the same time identifying polyps in the rectum and distal sigmoid - a direct indication for colonoscopy in order to avoid the multiple nature of the lesion.

Adenomatous (glandular) polyps are the most common.They are round formations on the leg or the wide basis, rarely bleed and ulcerate.

Adenomatous, villous (adenopapillomatoznye or zhelezistovorsinchatye) polyps are adenomatous usually larger in diameter and greater than 1 cm. At endoscopy, these polyps are seen as mnogodolchatye education.In fact, their appearance is due to mnogodolchaty an uneven surface, which may ulcerate, covered with fibrinous deposits and bleed.

villous tumor may reach large sizes.When endoscopy define them either as a polypoid formation on a long thick stalk, or in the form of education, creeping along the wall of the intestine to a considerable extent.Villous tumors have different colors the surface (from whitish to bright red), ulcerate, bleed and often ozlokachestvlyayutsya.

Treatment of colon polyps

Conservative treatment of colon polyps juice celandine herbs was proposed in 1965 by AM Amineva.However, it is not widely used due to lack of efficacy.Specialists involved in this issue, are against the use of celandine to treat polyps, as an attempt of the conservative influence on polyps leads to postponement of surgery.

most common methods of surgical treatment of colon polyps are:

  1. polypectomy with electrocoagulation through the endoscope stem or base of the polyp;
  2. transanal excision of tumors;
  3. kolotomiey tumor removal or resection of bowel transabdominal method.

Given the possibility of recurrence and malignancy of polyps, developed a system of clinical examination of patients after surgical treatment.It includes direct endoscopic control of the state and large intestine, especially in the most dangerous period - the first 2 years after surgery.During these years, the interval between endoscopic examination shall not exceed 6 months, and patients after removal of villous tumors, the most prone to recurrence and malignancy in the early stages, this interval does not exceed 3 months.

When relapse is recommended to re-surgery colon polyps, followed by systematic endoscopic control.In cases where the results of histological examination of polyps indicate the malignancy of the process, but at the base of the stem of the polyp or no signs of malignancy, the first endoscopic control study with multiple biopsy is performed at 1 month after surgery.With a favorable result of the biopsy, patients continue to be surveyed every 3 months, and in the future - 2 times a year.If invasive growth extends to the foot of the polyp or its base, shows radical cancer surgery.