Minilaparotomy Approach for the Resection of Laterally Spreading Tumors of the Colon

Abstract

Purpose

We report our experience of using the minimally invasive minilaparotomy approach to resect colonic laterally spreading tumors (LSTs) that could not be removed by colonoscopic snare polypectomy.

Methods

We prospectively examined 17 patients who underwent a minilaparotomy, defined as an incision less than 7 cm long, between 1997 and 2001, for a collective 19 colonic LSTs.

Results

Complete en bloc resection of the LSTs was successfully performed in all 17 patients. The resections included colotomy and polypectomy in four patients (four LSTs), limited colectomy in seven patients (nine LSTs), and colectomy with regional lymph node dissection in six patients (six LSTs). There was no mortality or morbidity. The mean ± standard deviation (SD) length of the minilaparotomy was 6.7 (±0.8) cm, and the mean (±SD) operating time and blood loss were 139 (±39) min and 27 (±15) ml, respectively. Histology revealed 2 adenomas, 16 Tis carcinomas, and 1 T1 carcinoma. None of the patients had lymph node metastasis or positive resection margins. There have been no signs of tumor recurrence after a median follow-up period of 30.4 months.

Conclusions

The minilaparotomy approach is appropriate for resecting LSTs that cannot be removed by colonoscopic snare polypectomy, and provides a minimally invasive alternative to conventional laparotomy.