colonic polyps

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shiva khan    on Nov 14, 2012 Says :

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good for study purpose
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jugal12,RGPV   favourited this   3 Years ago.
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2 : colonic polyps… Dr.S.Easwaramoorthy MS FRCS (Edin) FRCS (Eng) FRCS (Glas) Consultant Surgeon, Lotus hospital, Erode Honorary Faculty, PMCH, Perundurai Examiner, Royal College of surgeons of Edinburgh 10 Points for Practice DDC 2012 11.03.12
3 : Colonic polyps are not uncommon… 1 US/Autopsy Pedunculated Sessile polyps Incidence
4 : Polyps are asymptomatic… Symptomatic polyps Asymptomatic polyps Bleeding PR Anaemia Mucous discharge PR While evaluating for other GI symptoms Eg: Altered bowel habits Screening High risk people Previous ca colon Long H/O IBD F/O FAP/HNPCC 1st degree relatives of Ca colon IBD FAP 2
5 : Polyps are precancerous… APC K-ras p53 3
6 : Good, bad & Ugly polyps… 4
7 : Modalities for Detecting Polyps: Past, Present & Future… 5
8 : Newer modalities… Virtual Colonoscopy Capsule Colonoscopy Actual Virtual MDCT Good bowel preparation 3-D reconstruction of colon ‘Fly through’ the colon Sensitivity/specificity Special capsule with double lens 4 frames/Sec Image enhancement software Localization software
9 : Advances in Imaging Chromo endoscopy Narrow Band Imaging Magnification colonoscopy Endoscopic US 6 Indigocarmine NBI EUS White light Magnification
10 : Management of Polyps Snare polypectomy Saline elevation and removal ESD Tattooing/ Laparoscopy Laparotomy/Colectomy 7 Tattoo ESD Saline Injection/Snaring
11 : Polypectomy Specimen Report Malignant Polyp! What is next? Consider Surgery Poorly differentiated adeno ca Vascular/Lymphatic invasion < 2mm resection margin 8 Breach Muscularis Mucosa
12 : Familial Polyposis Syndromes 9
13 : Primary Prevention of Polyps… Diet Low in fat, High in Fruits, fibre, vegetables Weight reduction Avoid alcohol, Stop Smoking Consider Calcium, Folic acid, Selenium Aspirin Sulindac 10
14 : Thank You


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management of colonic polyps
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