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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What factors influence the risk of colon polyp recurrence?

Answered by
Dr.
Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions

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Posted on Wed, 25 Nov 2015 in Digestion and Bowels
Question: History of colon polyps. Had flat adenomatous flat cecal polyp removed by lap resection four years ago. Recent colonoscopy found another large flat cecal polyp; nodular and widespread. GI specialist recommends a lap cecectomy. I am 77 and am reluctant to keep chasing polyps by surgery. No cancer history and biopsy is negative for cancer cells. I will have another biopsy done in a year. Is this a "dumb" decision? Have type 2 diabetes under good control; slight heart murmur caused by aortic valve calcification; NO symptoms yet.
doctor
Answered by Dr. Muhammad Hanif 3 hours later
Brief Answer:
They will remain recurrent until we remove the cecum. Go for that!!!

Detailed Answer:
Thanks for the consultation at my virtual clinic!
I have carefully worked through your case, and can well realize your health worries. Being your physician, I will take care all of your medical concerns today and will put my best efforts to get you out of this situation.


I think you should go for the Laparoscopic Cecectomy as the polyps will come again and again and there is high chance that it may lead to a cancer of the gut. So it will be a good idea to go for surgical treatment as advised by your Gastroenterologist.

I can understand you may think that right now if there is no cancer on biopsy then why to go for a resection. But there are really high chances to develop in future and also when you have a recurring disease then better is to go for surgical correction instead of opting for a conservative management. I thinks its not a good idea to go for a serial biopsy when you have a good surgical option.

Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Muhammad Hanif 39 minutes later
Thank you for your advice. It has helped me get this problem on my priority list. Had you agreed with my "wait awhile" approach I would have done just that. Allow me please to request your opinion on me going to the Mayo Clinic in XXXXXXX FL; (not far for me)where advanced endoscopic procedures are used to remove flat polyps. They have surgical instruments and trained doctors who use recently developed procedures. I think it would be worth a try. That way I don't loose my cecum and small intestine valve unless their procedures do not work for my case. The consulting surgeon for the cecectomy would only say "Your bowel habits may change" Everyone has a different result and we will try to get you to normal asap but cant guaranty it." being a surgeon he didn't seem interested in any new approaches where the removal is done using the colonoscopy instrument. I greatly appreciate your discussion and would appreciate an answer to this additional question. I will give you a FIVE STAR rating for sure.
doctor
Answered by Dr. Muhammad Hanif 47 minutes later
Brief Answer:
You can opt in for conservative approach if you don't want a surgery!!!

Detailed Answer:
Welcome back and thanks for the consult.

It is totally upto you Sir. If you want to adopt wait awhile conservative approach, it is OK but remember to go serial diagnostic screenings especially keeping the suspicion of carcinoma in mind.

Yes--I recommend this centre for your work up and management. I remained attached to this centre and is really a great centre of excellence for GI procedures. You are good to go and join their program for conservative therapy and whenever needed they will help you for removal of polyps too. They also will remind you through XXXXXXX time to time for serial checkups. I suggest not to miss even a single appointment then as I have seen there many patients missing a single appointment and that actually was the Carcinoma diagnosing chance that they missed in the first place.

Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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