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Laparoscopic colorectal resection for benign polyps not suitable for endoscopic polypectomy

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Abstract

Background and aims

Endoscopic polypectomy still remains the cornerstone of therapy for colorectal polyps and adenomas. However, if colorectal polyps are too large or not accessible for endoscopic ablation or cannot be removed without an increased risk for perforation, operative procedures are required. In such circumstances, laparoscopic resection represents a minimally invasive alternative.

Materials and methods

Between January 1993 and December 2004, more than 2,500 endoscopic polypectomies were performed at the Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Germany. In patients which could not be treated by endoscopic polypectomy due to size, location, and/or risk of complications, a laparoscopic colorectal resection was performed. All data were prospectively assessed in our “colorectal resection” database.

Results

The database analysis revealed 58 patients with endoscopically not resectable colorectal polyps who underwent a laparoscopic colorectal resection (intend to treat). In 54 patients, the operative procedure could be finished by the laparoscopic approach (study population). The conversion rate was 6.9% (four of 58). An ileocolic resection was performed in 20 patients (37.0%), and 14 patients (25.9%) underwent an anterior rectal resection. A right colectomy was necessary in 12 patients (22.2%), and six patients (11.1%) underwent a sigmoid resection. In the remaining two patients, a left colectomy and a resection of the transverse colon were performed. Intra- and postoperative complications occurred in five patients (9.3%). Perioperative mortality was not registered. The histopathological work-up revealed benign disease in all cases.

Conclusion

Laparoscopic resection of colorectal polyps is a safe and minimally invasive technique for the management of benign colorectal tumors. Thus, the laparoscopic approach to endoscopically not resectable polyps enriches the therapeutic spectrum.

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Acknowledgment

Mrs. C. Killaitis is gratefully acknowledged for her help in keeping the “colorectal resection database” updated.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Ratzeburgerallee 160, 23538, Lübeck, Germany

    Lena Hauenschild, Franz Georg Bader, Tilman Laubert, Ralf Czymek, Philipp Hildebrand, Uwe Johannes Roblick, Hans-Peter Bruch & Lutz Mirow

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  1. Lena Hauenschild
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  2. Franz Georg Bader
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  3. Tilman Laubert
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  4. Ralf Czymek
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  7. Hans-Peter Bruch
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Correspondence to Lutz Mirow.

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The authors Hauenschild and Bader contributed equally to this work.

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Hauenschild, L., Bader, F.G., Laubert, T. et al. Laparoscopic colorectal resection for benign polyps not suitable for endoscopic polypectomy. Int J Colorectal Dis 24, 755–759 (2009). https://doi.org/10.1007/s00384-009-0688-0

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  • DOI: https://doi.org/10.1007/s00384-009-0688-0

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