Gastroenterology Center

Complex endoscopic resections

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Complex Endoscopic Resections In Gastroenterology

Complex Endoscopic Resections also known as Gastrointestinal Endoscopic Mucosal Resections or EMR, is a less invasive procedure than surgery for removing abnormal tissue from a person's digestive tract. This procedure may be done to either double check a diagnosis or for purposes of treatment.

Up to seventy-five percent of patients, suffering from complex colon polyps can now avoid surgery with this less invasive procedure. Patients that have been diagnosed with poor renal function, tumors of the digestive tract and bladder issues will all benefit from endoscopic resection. It is also useful for treating bile duct and pancreatic disorders.

The most common type of abnormal tissue found in the digestive tract is a small clump of cells that form on the inside of the colon known as a polyp. It occurs when the body's cells keep dividing after their original purpose, such as the building of tissue in the colon, has completed. Polyps are one type of adenoma or non-cancerous tumor found in the human colon. When a surgeon removes polyps from a person's colon that is said to be a complex polypectomy. The term 'complex' refers to the number, size, and or location of the polyps in a patient's colon.

There are many types of polyps, categorized by their shape and size. Approximately two-thirds of polyps are adenomatous or non-cancerous, though they may cause blockages depending on their size and location. Small and large serrated polyps are those that are believed to usually be precancerous and should be taken seriously. Patients with Crohn's disease or ulcerative colitis may have inflammatory polyps. These polyps are generally not a threat to a patient's overall health but anyone with these two disorders, among others, is at a higher risk to contract colon cancer and should have yearly physicals. People who are overweight, smokers and over age fifty are also at a higher risk to have colon cancer, as are those with a familial history of gastrointestinal issues.

Several inherited disorders may cause a person to have polyps. Gardner's syndrome causes polyps in the colon and small intestine and has been linked to benign tumors on the skin. A very rare disorder, Familial adenomatous polyposis, causes hundreds of polyps in the intestine and has an almost one hundred percent chance of colon cancer, often in people under forty years of age. Peutz-Jeghers syndrome cases freckles to form all over and inside the body, such as on the gums, bottom of the feet and on the inner walls of the intestines. Lynch syndrome is also called hereditary nonpolyposis colorectal cancer. It is unusual because people with this disease generally present with a small number of polyps, but those that occur tend to become cancer more quickly than in others.

Symptoms that often bring a patient to the gastroenterologist include rectal bleeding, change in stool color or bowel movement habits, pain, nausea or vomiting. Any patient that presents with anemia from being iron deficient may have one or more polyps that are bleeding, a serious condition that can lead to overall weakness and cause them to be short of breath. Any of these symptoms are a red flag and the patient is urged to contact their doctor, the sooner the better.

Polyps are removed because they can cause intestinal blockages and are occasionally cancerous later in life. Polyps may be small enough for a surgeon to remove in one piece. If they are three centimeters or larger they may have to be removed fragmentary or a small section at a time. It stands to reason that the larger the adenoma or polyp the higher risk for bleeding or infection to the patient.

A gastroenterologist, a doctor who specializes in the digestive system, always performs complex Endoscopic Resections. The risks associated with this procedure are much lower than those associated with surgery are and include only infections, bleeding, perforations or punctures, or the possible narrowing of the esophagus. When compared to surgery, adverse effects only occur in approximately six percent of endoscopic resections. Surgery, however, tends to increase hospital stays and risks of infection as well as higher costs for both the patient and the medical establishment.

Complex Endoscopic Resections are done with a long, narrow tube that is equipped with a light, video camera, and instruments for removing delicate tissue. However, this not the most comfortable procedure for the patient, sedation is used and the patient may be awake or not depending on the individual and what their doctor thinks is necessary for their comfort. It is an outpatient procedure and recovery typically takes less than a week. Patients are warned to avoid caffeine or stimulants for the first few days afterward to avoid irritating the colon.

Patients who take the time to listen and understand their diagnosis often have a better quality of life. Though it can be uncomfortable for the patient the Complex Endoscopic Resection has a better success rate and will get the patient back to doing what they like to do more quickly than surgery.