Polyps are precancerous lesions. Many studies have proven that colonoscopy and removal of polyps decreases the incidence of colorectal cancer. Countries with colorectal cancer screening programs have reported a significant drop in colorectal cancer cases and deaths. This is due to early detection of colorectal polyps with colonoscopy, the removal of which prevents the development of cancer.
The etiology is multi-factorial, with both environmental and genetic factors at play. These include:
Certain genetic conditions lead to development of polyps at a younger age. These genetic conditions include:
Polyps do not usually cause symptoms, unless they have become quite large, in which case, they may cause:
The treatment of polyps involves performing a colonoscopy and removing the entire polyp. The removed polyp is then sent for histological examination to determine if it is benign, or if malignant change has already occurred. Depending on the number and size of polyps removed, a follow up colonoscopy will be recommended anywhere from 1 year to 5 years later. If there are cancer cells found in the polyp, surgery may be required (see section on Colorectal Cancer).
Rectal polyps that are too large to be removed during colonoscopy, as well as early stage rectal cancers can be excised and removed via the anus. Traditionally, this was performed open. However, with the advent of transanal endoscopic equipment, transanal endoscopic resection allows rectal polyp removal to be performed under better vision and with improved accuracy.
During surgery, a special device that seals up the rectum and allows the maintenance of pneumo-rectum (where carbon dioxide is insufflated into the rectum) is inserted through the anus. This device also allows the insertion of instruments like a camera, grasping forceps and cutting devices. The pneumo-rectum and the high definition camera allow better vision, resulting in surgery performed with better accuracy.
Senior Consultant Colorectal Surgeon
MBBS, MMed (Surgery), FAMS, FRCSEd
Dr Tan Wah Siew is a Senior Consultant Colorectal Surgeon with experience in colorectal cancer, minimally invasive surgery and complex bowel conditions. Prior to private practice, she served as Senior Consultant at the Department of Colorectal Surgery at Singapore General Hospital and was the first female consultant colorectal surgeon in SGH's history. She was also among the earliest female general surgeons in Singapore trained in robotic colorectal surgery. Dr Tan further advanced her expertise through a Ministry of Health sponsored fellowship at St. James University Hospital in the United Kingdom, where she received specialised training in minimally invasive and robotic colorectal surgery, inflammatory bowel disease surgery and the management of advanced and recurrent pelvic cancers.
Mount Elizabeth Medical Centre
#08-07, 3 Mount Elizabeth, Singapore 228510
Tel: 6454 0054
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Fax: 6764 0054
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Email: ask@surgicalassociates.sg
Gleneagles Medical Centre
#05-01, 6 Napier Road, Singapore 258499
Tel: 6471 0054
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Fax: 6271 0054
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