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Laparoscopic colon resection for polyps: a good novice case?
Howard M Ross1, Christina Li, Julie Rosenthal
1Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Diseases of the Colon and Rectum
|April 7, 2006
Summary
Laparoscopic colon resection for unresectable polyps revealed a high incidence of invasive adenocarcinoma. Surgeons should exercise caution, as these cases require formal lymphadenectomy, not ideal for learning.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Laparoscopic colon resection for endoscopically unresectable polyps is often considered suitable for surgeons with moderate experience.
- This approach is favored due to non-inflamed tissues and potentially less extensive lymphadenectomy compared to cancer resections.
Purpose of the Study:
- To evaluate the incidence of invasive cancer in patients undergoing laparoscopic colon resection for polyps.
- To assess the appropriateness of using these resections as training cases for laparoscopic colectomy.
Main Methods:
- A retrospective review of 55 consecutive patients undergoing laparoscopic colon resection for endoscopically unresectable polyps.
- Analysis of colonoscopy data, polyp characteristics, and final colon pathology.
Main Results:
- Final pathology revealed invasive adenocarcinoma in 18.2% of patients.
- No specific patient or polyp characteristics predicted the presence of adenocarcinoma.
Conclusions:
- A significant proportion of endoscopically unresectable polyps are found to be adenocarcinoma upon resection.
- Laparoscopic resection of these polyps necessitates formal lymphadenectomy and should not be considered a routine "learning" case.