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Article: Laparoscopic colorectal resection for polyps not suitable for colonoscopic removal

TitleLaparoscopic colorectal resection for polyps not suitable for colonoscopic removal
Authors
KeywordsColonic polyp
Laparoscopic resection
Issue Date2005
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2005, v. 19 n. 9, p. 1252-1255 How to Cite?
AbstractBackground: Endoscopic removal of large sessile polyps is sometimes technically difficult and is associated with an increased risk of complications. Moreover, the incidence of invasive carcinoma within these polyps is not negligible. Laparoscopic colorectal resection has been recommended in the treatment of these large polyps. This study aimed to evaluate the outcomes of laparoscopic colorectal resection for polyps that were not suitable for colonoscopic removal. Methods: Forty-five patients (28 men and 17 women) who underwent laparoscopic colorectal resection with the preoperative diagnosis of colorectal polyps were analyzed. The reasons for surgical resection were large sessile polyps (n = 34), difficult position (n = 2), recurrence after transanal endoscopic microsurgery (n = 1), and the presence of intramucosal malignancy on histology after colonoscopic polypectomy (n = 8). Results: The mean age of the patients was 66.7 years (range, 33-89). Previous abdominal operation had been performed in 12 patients (26.7%). Two patients underwent subtotal colectomy because of multiple polyps (14 and 19, respectively). Synchronous resection of other organs was performed in two patients (a right salpingo-oophorectomy and a right adrenalectomy). Intraoperative complications occurred in two patients, and two patients (4.5%) required conversion because of perforation of the colon during dissection and dense adhesions, respectively. There was no postoperative mortality. Complications occurred in seven patients (15.6%), and they included postoperative ileus (n = 4), anastomotic leakage (n = 1), urinary retention (n = 1), and urinary tract infection (n = 1). Reoperation was required in one patient for anastomotic leakage. The median hospital stay was 6 days. The histopathology of colorectal polyps showed tubular (n = 12), tubulovillous (n = 13), and villous adenoma (n = 12); mixed adenomatous/hyperolastic polyps (n = 2); inflammatory polyp (n = 1); and colonic lipoma (n = 1). Four patients, who had previous polypectoray with intramucosal malignancy, had no residual pathology. The median size was 3.0 cm. Invasive carcinoma was found in 16 patients (35.6%). The median number of lymph node sampling was six, and two patients had lymph node metastases. Conclusions: Colonic polyps that were not amendable for colonoscopic removal were associated with a high incidence of malignant invasion. Laparoscopic colectomy offers safe and effective management of these polyps with the benefits of early postoperative recovery. © Springer Science+Business Media, Inc. 2005.
Persistent Identifierhttp://hdl.handle.net/10722/83298
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, SHen_HK
dc.contributor.authorLaw, WLen_HK
dc.date.accessioned2010-09-06T08:39:21Z-
dc.date.available2010-09-06T08:39:21Z-
dc.date.issued2005en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2005, v. 19 n. 9, p. 1252-1255en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83298-
dc.description.abstractBackground: Endoscopic removal of large sessile polyps is sometimes technically difficult and is associated with an increased risk of complications. Moreover, the incidence of invasive carcinoma within these polyps is not negligible. Laparoscopic colorectal resection has been recommended in the treatment of these large polyps. This study aimed to evaluate the outcomes of laparoscopic colorectal resection for polyps that were not suitable for colonoscopic removal. Methods: Forty-five patients (28 men and 17 women) who underwent laparoscopic colorectal resection with the preoperative diagnosis of colorectal polyps were analyzed. The reasons for surgical resection were large sessile polyps (n = 34), difficult position (n = 2), recurrence after transanal endoscopic microsurgery (n = 1), and the presence of intramucosal malignancy on histology after colonoscopic polypectomy (n = 8). Results: The mean age of the patients was 66.7 years (range, 33-89). Previous abdominal operation had been performed in 12 patients (26.7%). Two patients underwent subtotal colectomy because of multiple polyps (14 and 19, respectively). Synchronous resection of other organs was performed in two patients (a right salpingo-oophorectomy and a right adrenalectomy). Intraoperative complications occurred in two patients, and two patients (4.5%) required conversion because of perforation of the colon during dissection and dense adhesions, respectively. There was no postoperative mortality. Complications occurred in seven patients (15.6%), and they included postoperative ileus (n = 4), anastomotic leakage (n = 1), urinary retention (n = 1), and urinary tract infection (n = 1). Reoperation was required in one patient for anastomotic leakage. The median hospital stay was 6 days. The histopathology of colorectal polyps showed tubular (n = 12), tubulovillous (n = 13), and villous adenoma (n = 12); mixed adenomatous/hyperolastic polyps (n = 2); inflammatory polyp (n = 1); and colonic lipoma (n = 1). Four patients, who had previous polypectoray with intramucosal malignancy, had no residual pathology. The median size was 3.0 cm. Invasive carcinoma was found in 16 patients (35.6%). The median number of lymph node sampling was six, and two patients had lymph node metastases. Conclusions: Colonic polyps that were not amendable for colonoscopic removal were associated with a high incidence of malignant invasion. Laparoscopic colectomy offers safe and effective management of these polyps with the benefits of early postoperative recovery. © Springer Science+Business Media, Inc. 2005.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectColonic polypen_HK
dc.subjectLaparoscopic resectionen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshColonic Polyps - surgeryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLaparoscopyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRectum - surgeryen_HK
dc.titleLaparoscopic colorectal resection for polyps not suitable for colonoscopic removalen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=19&issue=9&spage=1252&epage=1255&date=2005&atitle=Laparoscopic+colorectal+resection+for+polyps+not+suitable+for+colonoscopic+removalen_HK
dc.identifier.emailLo, SH: hreclsh@hkucc.hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityLo, SH=rp00223en_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-004-2220-4en_HK
dc.identifier.pmid16132333-
dc.identifier.scopuseid_2-s2.0-27644461321en_HK
dc.identifier.hkuros126580en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27644461321&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1252en_HK
dc.identifier.epage1255en_HK
dc.identifier.isiWOS:000232343400018-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, SH=7401542444en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK

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