polypectomia

Polypectomia, or polypectomy, is a medical procedure to remove polyps, abnormal tissue growths that project from mucous membranes. It is most commonly performed during endoscopic examination of the gastrointestinal tract, especially the colon, but can also be applied to the stomach and other mucosal surfaces. The primary goal is to reduce the risk of cancer development and to treat polyps that cause symptoms such as bleeding or obstruction.

Indications include colorectal polyps detected during screening or surveillance, polyps with dysplastic changes, and symptomatic polyps. The procedure is usually performed during colonoscopy or upper endoscopy, often under local anesthesia or conscious sedation.

Techniques vary by size and morphology. Cold snare polypectomy is commonly used for diminutive and small polyps, while hot (electrocautery) snare polypectomy is employed for larger or more fibrous lesions. Cold forceps may be used for very small polyps. Larger or flat lesions may require endoscopic mucosal resection (EMR) to remove the lesion, or less commonly endoscopic submucosal dissection (ESD) for en bloc removal. If endoscopic removal is incomplete or not feasible, surgical resection may be necessary.

Pathology is performed on the retrieved tissue to determine histology and assess margins. Common risks include bleeding, perforation, and, rarely, infection or post-polypectomy syndrome. Management of antithrombotic therapy may influence peri-procedural planning.

Follow-up depends on polyp characteristics and histology, typically involving surveillance colonoscopy at intervals from about 3 to 7 years for average-risk patients, with shorter intervals for high-risk findings.