Why do some people who have intestinal polyps removed still have recurrences or even malignant changes?

First, we must have the concept of what is an intestinal polyp? Where is it most likely to occur? As the name suggests, an intestinal polyp is a lump of flesh that grows inside the intestine. The most common site of growth is the colorectum, especially the rectum, which is the main reason why the incidence of colorectal cancer is high. Intestinal polyps can be divided into non-neoplastic polyps and adenomatous polyps (also called neoplastic polyps). Non-neoplastic polyps are generally not cancerous, mainly including: 1. Juvenile polyps: common in young children, mostly under 10 years old. They often occur in the rectum, are round and spherical, mostly solitary, and are pathologically characterized by retention cystic cavities of varying sizes, which are a kind of misshapen tumor. 2.Inflammatory polyp: also known as pseudopolyp. Is the ulcer of the colonic mucosa in the healing process of fibrous tissue hyperplasia and ulcer submucosal edema, so that the normal mucosal surface gradually elevated and formed. They are commonly found in chronic ulcerative colitis, amebic dysentery, schistosomiasis, intestinal tuberculosis and other intestinal diseases. Adenomatous polyps are recognized as precancerous lesions. Adenomatous polyps can be divided into three types, namely tubular adenoma, villous adenoma and tubular choroidal adenoma, with tubular adenoma being the most common. Many intestinal polyps, especially adenomatous polyps, are precancerous in themselves, and if left untreated, they will basically become cancerous sooner or later, and this time is usually about 5 years. In principle, surgical removal of polyps is the best treatment. Small polyps are usually removed during colonoscopy and sent for pathological examination; while adenomas >3cm in diameter, especially villous adenomas, should be surgically removed: those below the peritoneal fold should be locally removed through the anus, and those above the peritoneal fold should be removed openly or under laparoscopy. But why do some patients have recurrence or even malignancy into cancer after removal of polyps? In this regard, first of all, we need to understand that the simple surgical treatment of intestinal polyps only removes the protruding polyps or diseased polyps, but not the treatment from the cause. On the other hand, after surgery, the causes and growth environment of intestinal polyps still exist, which is why intestinal polyps recur after surgery. Recurrence of polyps and cancer are more frequent in patients with colorectal polyps after polypectomy. In general, the risk of recurrence increases from 20% at 5 years after surgery to 50% at 15 years after surgery, and the recurrence rate is even higher for multiple polyps, which can be as high as 80% at 15 years after surgery. The highest rate of local recurrence is seen in choriocapillary adenomas and mixed adenomas, which are generally considered to be due to improper removal of the original tumor, resulting in residual tumor. Studies show that recurrent adenomas have the potential risk of cancer, and the chance of developing colorectal cancer after surgery for villous adenoma is more than 8 times higher than that of normal people. At the same time, colorectal adenoma has the tendency of multiple occurrences, and multiple adenomas can occur simultaneously or sequentially, so it is necessary to follow up and observe patients after colorectal adenoma surgery. So, besides regular review, what else can be done to prevent recurrence or occurrence of intestinal polyps? Studies have confirmed that the following recommendations can keep you away from colon polyps: 1. Actively treat chronic intestinal inflammatory diseases and other underlying diseases. Inflammatory diseases of the intestine, mostly accompanied by diarrhea, long-term diarrhea will damage the mucosa of the large intestine, which over time will lead to hyperplasia of the intestinal wall, which will cause intestinal polyps. 2, to develop good habits of life and rest. Often stay up late will aggravate the patient’s body acidity, will increase the risk of intestinal polyps, especially for young people, it is important to change bad habits. 3, maintain a good state of mind. The combination of work and rest a healthy state of mind can enhance the body’s blood circulation capacity, strengthen the body’s immunity, which is very helpful in the prevention of intestinal polyps. 4.Adequate exercise. Obesity is also a high-risk factor for the occurrence of intestinal cancer, so moderate exercise can promote intestinal peristalsis, which can effectively prevent constipation and accelerate the metabolism of human body during sweating to eliminate human waste. 5.Good dietary habits. Dietary factors, especially the increase in the proportion of red meat and meat dishes is one of the most important factors leading to intestinal tumors, diet should be based on green vegetables and fruits, reduce the consumption of red meat and fatty meat, pickled and smoked food should be eaten less. 6. Quit smoking and limit alcohol. This is also a high-risk factor for the occurrence of intestinal tumors, which also easily leads to some other basic diseases, so we’d better avoid these habits.