Authors: Dirk Wilhelm Stefan von Delius Lars Weber Alexander Meining Armin Schneider Helmut Friess Roland M Schmid Eckart Frimberger Hubertus Feussner
Publish Date: 2009/01/24
Volume: 23, Issue: 4, Pages: 688-693
Abstract
Large colorectal polyps or those that are difficult to access may be unamenable to conventional snare polypectomy and may require surgical resection This study was designed to evaluate the resection of such lesions by the use of combined laparoscopic–endoscopic resections CLERPatients who had received CLER for colorectal polyps between January 1997 and December 2006 were identified from a prospectively maintained database Patients with biopsies consistent with invasive cancer were excluded from the combined approach Baseline characteristics surgical pathological postoperative and followup data of patients and lesions were reviewedA total of 146 consecutive patients underwent CLER for 154 lesions and 120 82 patients underwent local excision ie laparoscopyassisted endoscopic resection endoscopyassisted wedge resection and endoscopyassisted transluminal resection Twentysix 18 patients received endoscopyassisted segmental colon resection Conversion rate was 5 and intraoperative complications occurred in two patients 1 Major postoperative complications occurred in five patients 3 necessitating surgical reintervention in four of them Followup colonoscopy revealed metachronous adenomas in 33 patients of which 8 patients showed macroscopic or microscopic characteristics of advanced lesions One patient who had been converted to open resection because of incomplete laparoscopic resection of an adenoma developed relapse of the initial adenoma and was successfully treated with repeat CLER accounting for a local recurrence rate of 09
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