Outcome of laparoscopic colectomy for polyps not suitable for endoscopic resection

Pokala, Naveen; Delaney, Conor P.; Kiran, Ravi P.; Brady, Karen; Senagore, Anthony J.

doi:10.1007/s00464-006-9069-8

Cited by 57 publications

(53 citation statements)

References 30 publications

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“…Überwiegend wird die laparoskopische Resektion gegenüber der offenen favorisiert. Mehrere Studien belegen die Über-legenheit der Laparoskopie, insbesondere was den frühen postoperativen Verlauf angeht [17,18,19]. Bei schwierigen Lokalisationen, besonderes im Bereich des Colon transversum, ist jedoch die individuelle Expertise des Chirurgen zu berück-sichtigen und ggf.…”

Section: Laparoskopieunclassified

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Rüth

Spatz

Anthuber

2011

Chirurg

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The knowledge that due to the adenoma-cancer sequence polyps will develop sooner or later into invasive cancer demands the complete removal of colorectal polyps. The majority of polyps can be endoscopically removed. The indications for surgical removal of polyps are a previous incomplete endoscopic resection, location not amenable to endoscopic removal and lesions which are macroscopically highly suspicious for malignancy and cannot be detached by submucosal saline injection. If a surgical approach is indicated minimally invasive surgery in the hands of an experienced laparoscopic surgeon is a suitable option. Adenomas suspicious for malignancy in the lower two thirds of the rectum should not be treated by time-consuming endoscopic submucosal dissection (ESD) and can be quickly and safely removed transanally, conventionally or by transanal endoscopic microsurgery (TEM) by a full thickness én bloc resection. This allows the pathologist to determine the depth of invasion and the completeness of resection in terms of the circumferential margin and a definitive radical surgical approach is only necessary in high risk situations.

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Section: Laparoskopieunclassified

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Rüth

Spatz

Anthuber

2011

Chirurg

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“…The mean size of the resected polyps were 2.0 [11] to 3.1 cm [10]. In the largest series of 525 patients, the overall incidence of cancer was 18.1% (T1: 44.2%, T2: 37.9%, T3: 16.8%, and T4: 1.1%) [8].…”

Section: Results Of Laparoscopic Resection Of Colonic Polypsmentioning

confidence: 99%

“…Hospital stay is reported to be 3–11 days. In a study of 51 consecutive patients, 4 patients were readmitted (7.8%) and 2 patients were reoperated (3.9%) [10]. …”

Section: Results Of Laparoscopic Resection Of Colonic Polypsmentioning

confidence: 99%

Combined Endoscopic-Laparoscopic Resection of Colon Polyps

Hahnloser¹

2012

Dig Dis

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Aims: To analyze the current literature on combined endoscopic-laparoscopic resection of colon polyps and to compare this new approach to standard laparoscopic colonic resection for polyps not suitable for endoscopic resection. Results: Several studies demonstrated that with a combined endoscopic-laparoscopic approach, polyps were successfully resected in 82–91% with a low morbidity of 3–10% and a short hospital stay of 1–2 days. Segmental laparoscopic resection was necessary in only 9–12%, but had a conversion rate to open surgery of 15% with an average hospital stay of 6–11 days. A cancerous polyp was found in 6–13% after a combined approach, with lymph node metastasis in 6%. Recurrent polyps after a combined endoscopic-laparoscopic resection seem to be rare, but follow-up of most studies is short and incomplete. Conclusion: Combined endoscopic-laparoscopic resection of colon polyps is feasible, safe, and has a high success rate. Malignant lesions can be treated laparoscopically during the same operation, avoiding the need for a second procedure, and with good long-term oncologic outcome.

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“…Colonoscopically unresectable polyps have a 20% incidence of harboring occult invasive adenocarcinoma [6,7]. Ideally, complete removal is performed to allow full histologic evaluation to exclude malignancy.…”

Section: Laparoscopic-assisted Colonoscopic Polypectomymentioning

confidence: 99%

Emerging technologies including robotics and natural orifice transluminal endoscopic surgery (NOTES) colorectal surgery

Whiteford

Swanström

2007

Journal of Surgical Oncology

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Endoluminal and minimally invasive techniques have a long history and bright future in colorectal surgery. First, we will examine how old (colonoscopy) and new (laparoscopy) techniques combine in the form of laparoscopically assisted colonoscopic polypectomy for removal of "colonoscopically unresectable" colon polyps. Next, we will review the early experiences with robot-assisted minimally invasive colon resections. Lastly, we will introduce the next frontier in minimally invasive surgery, natural orifice transluminal endoscopic surgery (NOTES).

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Outcome of laparoscopic colectomy for polyps not suitable for endoscopic resection

Cited by 57 publications

References 30 publications

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Combined Endoscopic-Laparoscopic Resection of Colon Polyps

Emerging technologies including robotics and natural orifice transluminal endoscopic surgery (NOTES) colorectal surgery

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