BACKGROUND: For complex right colon polyps, not removable using colonoscopy, right colon resection is considered the optimal treatment. Combined endoscopic-laparoscopic surgery, using both laparoscopy and CO2 colonoscopy, has been introduced as a new approach for these complex colon polyps with intent to avoid bowel resection. OBJECTIVE: This study aimed to evaluate the safety and outcomes of combined endoscopic-laparoscopic surgery used for treatment of complex right colon polyps. DESIGN: This is a retrospective study of patients undergoing combined endoscopic-laparoscopic surgery for treatment of benign right colon polyps from 2003 to 2008. SETTINGS: This is a single-institution study. PATIENTS: Twenty-three patients with complex right colon polyps were included. MAIN OUTCOME MEASURES: The main outcome measures included the length of hospital stay, postoperative complications, and polyp recurrence. RESULTS: Of 23 patients, 20 (87%) patients had their polyp removed successfully by combined endoscopic-laparoscopic surgery and 3 (13%) needed laparoscopic resection, after laparoendoscopic evaluation. The median length of hospital stay was 2 days (range, 1-5), and there were no postoperative complications. Median follow-up time was 12 months. Three patients had recurrent polyps, and the recurrence-free interval at 36 months was 55.7% (95% CI = 8.6%, 87.0%). All recurrences were benign polyps and were removed by colonoscopic snaring. CONCLUSIONS: Combined endoscopic-laparoscopic surgery can be safely offered to selected patients with benign right colon polyps that can not be removed by colonoscopy. This combined approach may provide a viable alternative to right colon resection for complex benign colon lesions and warrants future investigation.
BACKGROUND: For complex right colon polyps, not removable using colonoscopy, right colon resection is considered the optimal treatment. Combined endoscopic-laparoscopic surgery, using both laparoscopy and CO2 colonoscopy, has been introduced as a new approach for these complex colon polyps with intent to avoid bowel resection. OBJECTIVE: This study aimed to evaluate the safety and outcomes of combined endoscopic-laparoscopic surgery used for treatment of complex right colon polyps. DESIGN: This is a retrospective study of patients undergoing combined endoscopic-laparoscopic surgery for treatment of benign right colon polyps from 2003 to 2008. SETTINGS: This is a single-institution study. PATIENTS: Twenty-three patients with complex right colon polyps were included. MAIN OUTCOME MEASURES: The main outcome measures included the length of hospital stay, postoperative complications, and polyp recurrence. RESULTS: Of 23 patients, 20 (87%) patients had their polyp removed successfully by combined endoscopic-laparoscopic surgery and 3 (13%) needed laparoscopic resection, after laparoendoscopic evaluation. The median length of hospital stay was 2 days (range, 1-5), and there were no postoperative complications. Median follow-up time was 12 months. Three patients had recurrent polyps, and the recurrence-free interval at 36 months was 55.7% (95% CI = 8.6%, 87.0%). All recurrences were benign polyps and were removed by colonoscopic snaring. CONCLUSIONS: Combined endoscopic-laparoscopic surgery can be safely offered to selected patients with benign right colon polyps that can not be removed by colonoscopy. This combined approach may provide a viable alternative to right colon resection for complex benign colon lesions and warrants future investigation.
Authors: Scott R Steele; Eric K Johnson; Bradley Champagne; Brad Davis; Sang Lee; David Rivadeneira; Howard Ross; Dana A Hayden; Justin A Maykel Journal: World J Gastroenterol Date: 2013-07-21 Impact factor: 5.742
Authors: Alberto Arezzo; Roberto Passera; Marco Migliore; Roberto Cirocchi; Giuseppe Galloro; Raffaele Manta; Mario Morino Journal: United European Gastroenterol J Date: 2015-12 Impact factor: 4.623
Authors: Minna K Lee; Formosa Chen; Eric Esrailian; Marcia McGory Russell; Jonathan Sack; Anne Y Lin; James Yoo Journal: Surg Endosc Date: 2013-01-10 Impact factor: 4.584
Authors: Fernando A Angarita; Adina E Feinberg; Stanley M Feinberg; Robert H Riddell; J Andrea McCart Journal: Int J Colorectal Dis Date: 2017-12-28 Impact factor: 2.571