Rectal polyps and tumors are abnormal growths that occur in the rectum, the last part of the large intestine. These growths can be either benign (non-cancerous) or malignant (cancerous), and they can cause a range of symptoms and complications.

The diagnosis and treatment of rectal polyps and tumors have significantly improved over the years, with various endoscopic and microsurgical approaches now available for their management.

Types of Rectal Polyps

Rectal polyps can be classified into different types based on their characteristics and cellular makeup. The most common types include:.

1. Adenomatous Polyps

Adenomatous polyps are the most common type of polyps found in the rectum. These polyps have the potential to develop into cancer over time if left untreated. Therefore, they are usually removed during colonoscopy to reduce the risk.

2. Hyperplastic Polyps

Hyperplastic polyps are usually small and rarely turn into cancer. They are generally harmless, but their presence may indicate an increased risk of developing other types of polyps.

3. Serrated Polyps

Serrated polyps, also known as serrated adenomas, have a saw-toothed appearance when viewed under a microscope. Some serrated polyps can progress to cancer and are often associated with a family history of colorectal cancer.

Rectal Tumors

Rectal tumors, on the other hand, refer to abnormal growths that are cancerous. These tumors can either be primary rectal cancer, which originates in the rectum, or metastatic tumors that have spread from other parts of the body.

Endoscopic Approach to Rectal Polyps and Tumors

Endoscopy plays a crucial role in the diagnosis and treatment of rectal polyps and tumors. Endoscopic procedures involve the use of a flexible tube with a camera and light source (endoscope) to visualize and access the rectal area.

1. Colonoscopy

Colonoscopy is the gold standard for detecting and removing rectal polyps. During this procedure, the colonoscope is passed through the rectum to examine the entire colon and rectum.

If any polyps are found, they can be removed using specialized instruments passed through the colonoscope.

2. Endoscopic Mucosal Resection (EMR)

Endoscopic mucosal resection (EMR) is a technique used to remove larger polyps or early-stage cancers that have not penetrated the deeper layers of the rectal wall.

Through the colonoscope, the polyp or tumor is carefully lifted and cut away from the underlying tissue.

3. Endoscopic Submucosal Dissection (ESD)

Endoscopic submucosal dissection (ESD) is a more advanced endoscopic technique that allows for en bloc resection of larger polyps or early-stage rectal tumors. ESD involves lifting the lesion and then dissecting beneath it to achieve complete removal.

Microsurgical Approach

In some cases, rectal polyps or tumors may require microsurgical treatment. Microsurgery involves the use of a high-powered microscope and specialized surgical instruments to meticulously remove the growths.

1. Transanal Microsurgery (TAMIS)

Transanal microsurgery (TAMIS) is a minimally invasive surgical technique performed through the anus. This approach allows for the removal of certain larger rectal polyps and early-stage tumors while minimizing trauma and promoting faster recovery.

2. Transanal Endoscopic Microsurgery (TEM)

Transanal endoscopic microsurgery (TEM) is another microsurgical procedure used for the removal of larger rectal polyps and early-stage rectal tumors. TEM provides excellent visualization and precise dissection capabilities.

Complications and Follow-up

After the removal of rectal polyps or tumors, it is essential to monitor for any complications and provide appropriate follow-up care. Complications can include bleeding, infection, or recurrence of polyps or tumors.

Conclusion

The endoscopic and microsurgical approaches to rectal polyps and tumors offer effective and minimally invasive treatment options.

The choice of the specific approach depends on the characteristics of the polyps or tumors, their size, and the individual patient’s overall health condition. Early detection and timely intervention play a crucial role in improving outcomes and reducing the risk of developing advanced rectal cancer.