Colon cancer: colonoscopy

Colonoscopy is a fundamental test for finding and diagnosing colon cancer. It is done under light general anesthesia (the person is hardly asleep - deep sedation) for the comfort of the patient and the doctor.

Colonoscopy has a double interest: diagnosis and treatment. Indeed, not only colonoscopy is the first reliable examination, but, it also allows to remove one or polyps that may or may not be cancerous.

The endoscopist (a gastroenterologist) has the necessary instruments to remove the lesion, when it is superficial (it has not begun to extend into the wall at depth). For a long time, only certain forms of so-called "pedunculated" polyps, which had a mushroom shape with a hat and a foot, could be removed at colonoscopy.

Now, new techniques (mucosectomy) can remove most of the other polyps flatter than the pedicles. For this reason, when the polyp is not mushroom-shaped, when its base is very wide, the doctor injects a liquid under the polyp with a needle to lift it. This makes it possible to move the polyp away from the muscle to which it is attached, and extract it without risk of perforating the colon muscle. The doctor places a lasso around the base of the polyp, as close as possible to the wall of the colon. Then he circulates a weak electric current in the metal loop that tightens to cut the polyp. The electric current prevents bleeding, then the polyp is removed and examined under a microscope.

How is a colonoscopy?

In addition to the gastroenterologist, you must meet the anesthetist doctor for a preparatory consultation. The day before surgery, you will need to cleanse your bowel. For this, the doctor will have prescribed a laxative liquid to drink. On the day of the colonoscopy, you arrive at the hospital or clinic, on an empty stomach, in the morning or a few hours before the exam.

The anesthesia is of very short duration and superficial (deep sedation). Unless you have a problem, you go home the same evening. During the procedure, a flexible tube with a very fine camera is introduced through the anus, and your colon is inflated with air to visualize the inside of your intestine.

And after the colonoscopy?

The polyp (es) that have been removed will need to be analyzed to see if they are cancerous or not. If the polyps are not cancerous, a simple surveillance is enough. If the polyps are cancerous, it depends on the stage of invasion. If the cancer does not reach the depth of the submucosa, the colonoscopy may be sufficient: no surgery will be considered.

If there is a risk of ganglion invasion, remove part of the colon with the lymph nodes around and consider, depending on the case, post-operative chemotherapy called "adjuvant".

Everything that was removed during colonoscopy (polyp or other tumor) is then analyzed in an anatomopathology laboratory to look for particularly malignant tumor cells.

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Read also :

Chemotherapy: how is it going?
The pathologist: who is he?

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