OBJECTIVE: To determine to what extent segmental colectomy could be avoided in patients with polyps though to be endoscopically unresectable by using combination laparoscopy and endoscopy. METHODS: Sixty-five patients referred for colonic polyps though to be unresectably by conventional endoscopy were studied. After analysis of the endoscopic findings, endoscopy was performed in a medicosurgical unit when possible, otherwise a surgical procedure was performed consisting of laparoscopy followed by colonoscopy. Therapeutic strategy depended on laparoscopic and endoscopic findings. RESULTS: Segmental colectomy was avoided in 44 patients (67.7%). Among them, 20 were treated by simple endoscopic polyp removal, 12 by laparoscopy-assisted colonoscopic polypectomy, 9 by laparoscopic wedge colonic resection and 3 by colotomy after colonic exteriorization and polyp resection. Laparoscopic or laparoscopy-assisted segmental colectomy was performed in 16. Segmental colectomy by laparotomy was necessary in 5. No complication occurred. CONCLUSION: Segmental colectomy for unresectable colonic polyps could be avoided in more than half of the patients using laparoscopy and colonoscopy combinations.
OBJECTIVE: To determine to what extent segmental colectomy could be avoided in patients with polyps though to be endoscopically unresectable by using combination laparoscopy and endoscopy. METHODS: Sixty-five patients referred for colonic polyps though to be unresectably by conventional endoscopy were studied. After analysis of the endoscopic findings, endoscopy was performed in a medicosurgical unit when possible, otherwise a surgical procedure was performed consisting of laparoscopy followed by colonoscopy. Therapeutic strategy depended on laparoscopic and endoscopic findings. RESULTS: Segmental colectomy was avoided in 44 patients (67.7%). Among them, 20 were treated by simple endoscopic polyp removal, 12 by laparoscopy-assisted colonoscopic polypectomy, 9 by laparoscopic wedge colonic resection and 3 by colotomy after colonic exteriorization and polyp resection. Laparoscopic or laparoscopy-assisted segmental colectomy was performed in 16. Segmental colectomy by laparotomy was necessary in 5. No complication occurred. CONCLUSION: Segmental colectomy for unresectable colonic polyps could be avoided in more than half of the patients using laparoscopy and colonoscopy combinations.
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: M E Franklin; A Leyva-Alvizo; D Abrego-Medina; J L Glass; J Treviño; P P Arellano; Guillermo Portillo Journal: Surg Endosc Date: 2007-02-23 Impact factor: 4.584