The treatment principle of colorectal polyps is to remove the polyps immediately. At present, the main methods to remove polyps are endoscopic removal.
According to the shape, size and quantity of polyps and the presence, length and thickness of pedicle:
① High frequency electrocoagulation snare resection: mainly used for pedicled polyps;
② High frequency electrocoagulation: mainly used for multiple hemispherical small polyps;
③ High frequency electrocoagulation hot biopsy forceps: at present, it is rarely used, which is mainly replaced by ② ④ method;
④ Biopsy forceps removal: it is mainly used for single or a few small spherical polyps, which is simple and easy, and can also be used for biopsy;
⑤ Laser gasification and microwave diathermy; Suitable for those who do not need to keep histological specimens;
⑥ Mucosal dissection and inlay: mainly used in patients with flat polyps or early cancer;
⑦ "Close connection" removal method is mainly used for long pedicled large polyps. If it is difficult to hang in the intestinal cavity, large polyps close connection intestinal wall electrocoagulation resection method is used.
⑧ Staged and batch resection is mainly used for patients with more than 10 ~ 20 polyps who cannot be removed at one time.
⑨ The combined treatment of endoscopy and surgery is mainly used for patients with polyposis, that is, the sparse area of polyps is surgically removed, so as to achieve the purpose of treatment and maintain the normal function of large intestine.
Because colorectal polyps, especially adenomatous polyps, have been recognized as precancerous lesions by scholars, the regular follow-up of patients with colorectal polyps has been mentioned to the high degree of prevention and treatment of early colorectal cancer. Regular follow-up of colorectal polyps, especially adenomatous polyps, is an important part to prevent malignant transformation of polyps.
The re detection rate of polyps is high, ranging from 13% to 86% in foreign reports. In addition to some recurrent polyps with residual polyps growing again, some of the newly detected polyps are new polyps and missing polyps of large intestine. In order to keep the intestinal polyp free state and prevent the occurrence of colorectal cancer, it is necessary to formulate an economic and effective follow-up time. At present, the follow-up time of adenoma is necessary in the world. At present, many schemes have been put forward for the follow-up of adenoma in the world. The colorectal adenoma group discussed the proposed scheme in detail at the Third International Conference on colorectal cancer held in Boston. They pointed out that patients with adenomas have different risks of recurrent new adenomas and local adenomas after adenoma resection, so they should be treated differently: adenomas with single, pedicled (or broad-based but < 2cm tubular adenomas) and mild or moderate atypical hyperplasia belong to the low-risk group. Those with one of the following conditions belong to the high-risk group: multiple adenomas, adenomas with a diameter of > 2cm, broad-based villous or mixed adenomas, adenomas with severe atypical hyperplasia or carcinoma in situ, and adenomas with invasive canceration. The follow-up plan of the high-risk group is adenoma resection and endoscopy from 3 to 6 months. If it is negative, it can be checked again every 6 to 9 months. If it is negative again, it can be checked every 1 year. If it is still negative, it can be checked again every 3 years, but fecal occult blood should be checked every year. The adenomas in the low-risk group were rechecked one year after adenoma resection. If they were negative, they could be examined once every three years, a total of two times, and then once every five years. However, during the follow-up time, fecal occult blood test must be performed every year. Once polyps were found during reexamination, they were removed by endoscopy.