multiple colorectal polyps

[pmnovak]

My surgeon has suggested laprascopic colon removal with small intestine reconnected to rectum because some of the polyps were/are pre cancerous.   Is this a serious/difficult operation and how will it affect my daily habits and life style?  I am 70 years old, very active, thin, and in incredibly good health except for a chance colonoscopy that found a kazillion polyps, albeit without any symptoms.   What went wrong, how do polyps develop, how can I rid myself of them besides and operation?

[Morecambe]

Hi - you need to ask your surgeon how these polyps develop - but I suppose it is genetic and probably accelerated by smoking/bad dietary habits etc etc.  All the usual non-specific waffle...!!

Surgical excision - i.e. a total colectomy - has probably been recommended to you as the most favourable option which ought to prevent the onset of colon cancer from the polyps.  In other words, if nothing was done then you might develop colon cancer.  I suppose that the presence of multiple polyps excludes "snipping them off" during a colonoscopy - easier to cut out the whole section.

I underwent a total colectomy for torrential diverticular bleeding five years ago.  This was a full "surgeon's hands inside the abdomen" rather than a laparoscopic technique - the latter supposedly enabling quicker recovery due to its greater "non-invasive" methodology.

In response to another Medhelp patient, I placed the experience of my operation on Medhelp and you can read this on:-

http://www.medhelp.org/posts/show/523166

I suggest that you may like to print this off and show it to your surgeon and ask him/her "is this likely to be my own experience - more or less?"  A total colectomy is a big operation and it will take time to recover.

Last suggestion - I would recommend a surgical team/hospital where total colectomies (also called ileorectal anastomosis) are carried out all day/every day.  Try to engage a surgeon who is a specialist G.I. surgeon rather than a "general surgeon" who carries out occasional colectomies as well as hernias, sawing off legs and ingrowing toenails!!

Good luck and do come back if you have any more questions

regards
Morecambe

[pmnovak]

Thank you, thank you for the words of encouragement re. 523166.   I live in a fairly isolated community so health program dictates who and where you have medical care.  However, my doctor just phoned and is requesting another colonoscopy to remove 20 to 30 polyp tissue samples to be forwarded to labs in Calgary and Vancouver.  If the results do not definitively diagnose adenomatous characteristics then we wait on the operation and have colonoscopies every four months until such time as we get a definite cancer result which may be years or months or never.  In the meantime I get to climb as many mountains as I can handle and hike as many trails as I can find.  Maybe.  The colonoscopy is scheduled for May 22.  I will stay in touch.  Thanks, again.

[Morecambe]

Sounds a reasonable programme of action - if the operation can be avoided without risk of allowing colon cancer to gain a foothold then that is surely preferable.

At the risk of becoming boring, if an operation is eventually advised, I do feel that you should ensure that your proposed hospital/surgeon is 100% up to speed on the technique.  For instance, how many total colectomies has he/she carried out - and over what period of time?  And can the operation be performed laparoscopically?  If not, then is this due to the surgeon's inexperience with this less invasive technique?  Also I have gained the feeling that less experienced surgeons are more likely to perform the operation in a manner where a stoma bag has to be connected whereas specialist G.I. surgeons have more success in avoiding this.

It is often difficult to ask surgeons questions about their experience and competence.  Many will willingly tell you - but some act like God although they are no nearer to the Almighty than you or me!!

Anyway good luck - and do let us know your progress.

regards
Morecambe