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The short-term outcomes of laparoscopic–endoscopic cooperative surgery for colorectal tumors (LECS-CR) in cases involving endoscopically unresectable colorectal tumors

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Abstract

Purpose

Laparoscopic and endoscopic cooperative colorectal surgery (LECS) is widely used for the removal of endoscopically unresectable colonic polyps. We evaluated the invasiveness of LECS in comparison to conventional laparoscopic surgery (CLS) for endoscopically unresectable colorectal tumors.

Method

We retrospectively analyzed the data of patients with colorectal adenoma or mucosal cancer and submucosal tumors who underwent either LECS or CLS at a single, high-volume center in Japan between 2004 and 2017. The short-term and oncological outcomes were compared between groups.

Results

Of the 83 eligible patients, 15 underwent LECS and 68 underwent CLS. There was no conversion to open surgery in either group. En bloc resection was achieved in all cases in both groups. The median time to solid diet intake was the same in both groups (2 days, p = 0.39). The median duration of hospital stay after surgery was 6 days (range 4–12 days) in the LECS group and 10 days (range 5–68 days) in the CLS group (p = 0.01). Clavien–Dindo grade ≥ 3 postoperative complications only occurred in the CLS group (two cases, p = 0.37).

Conclusion

Our results indicated that LECS is a safe and feasible technique that results in high-quality colorectal polyp resection with quicker recovery and favorable 30-days postoperative outcomes.

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References

  1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;383:1490–502.

    Article  Google Scholar 

  2. Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.

    Article  CAS  Google Scholar 

  3. Winawer SJ, Zauber AG. Incidence reduction following colonoscopic polypectomy. Am J Gastroenterol. 2011;106:370.

    Article  Google Scholar 

  4. Zhang M, Shin EJ. Successful endoscopic strategies for difficult polypectomy. Curr Opin Gastroenterol. 2013;29:489–894.

    PubMed  Google Scholar 

  5. Gallegos-Orozco JF, Gurudu SR. Complex colon polypectomy. Gastroenterol Hepatol. 2010;6:375–82.

    Google Scholar 

  6. Fukunaga Y, Tamegai Y, Chino A, Ueno M, Nagayama S, Fujimoto Y, et al. New technique of en-bloc resection of colorectal tumor using laparoscopy and endoscopy cooperatively (laparoscopy and endoscopy cooperative surgery—colorectal). Dis Colon Rectum. 2014;57:267–71.

    Article  Google Scholar 

  7. Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, et al. Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 2008;22:1729–35.

    Article  CAS  Google Scholar 

  8. National Cancer Institute (USA). Cancer Therapy Evaluation Program. Common Terminology Criteria for Adverse Events (CTCAE) v5.0. 2003. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_50. Accessed 16 Apr 2019.

  9. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  Google Scholar 

  10. Beck DE, Karulf RE. Laparoscopic-assisted full-thickness endoscopic polypectomy. Dis Colon Rectum. 1993;36:693–5.

    Article  CAS  Google Scholar 

  11. Franklin ME Jr, Portillo G. Laparoscopic monitored colonoscopic polypectomy: long-term follow-up. World J Surg. 2009;33:1306–9.

    Article  Google Scholar 

  12. Schmidt A, Beyna T, Schumacher B, Meining A, Richter-Schrag HJ, Messmann H, et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut. 2018;67:1280–9.

    Article  Google Scholar 

  13. Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Clinical Outcomes of Surgical Therapy Study Group, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.

  14. Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S, et al. JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc. 2015;27:417–34.

    Article  Google Scholar 

  15. Sanchez-Yague A, Kaltenbach T, Raju G, Soetikno R. Advanced endoscopic resection of colorectal lesions. Gastroenterol Clin N Am. 2013;42:459–77.

    Article  Google Scholar 

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Authors and Affiliations

  1. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Shinsuke Suzuki, Yosuke Fukunaga, Takashi Akiyoshi, Tsuyoshi Konishi, Satoshi Nagayama & Masashi Ueno

  2. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Kanagawa, Japan

    Shinsuke Suzuki

  3. Gastroenterological Center, Department of Gastroenterological Endoscopy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Yoshiro Tamegai & Shoichi Saito

Authors
  1. Shinsuke Suzuki
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  2. Yosuke Fukunaga
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  3. Yoshiro Tamegai
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  4. Takashi Akiyoshi
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  5. Tsuyoshi Konishi
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  6. Satoshi Nagayama
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  7. Shoichi Saito
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  8. Masashi Ueno
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Corresponding author

Correspondence to Yosuke Fukunaga.

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The authors declare no conflict of interest in association with the present study.

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Suzuki, S., Fukunaga, Y., Tamegai, Y. et al. The short-term outcomes of laparoscopic–endoscopic cooperative surgery for colorectal tumors (LECS-CR) in cases involving endoscopically unresectable colorectal tumors. Surg Today 49, 1051–1057 (2019). https://doi.org/10.1007/s00595-019-01840-7

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