Safe endoscopic treatment of large colonic lipomas using endoscopic looping technique

Colonic lipomas are benign, submucosal tumours that are usually asymptomatic. Typically, they are incidentally diagnosed during colonoscopy. Due to a low prevalence, the natural history of lipomas remains largely unknown. While large (>2 cm) lesions can cause symptoms and complications, their endoscopic treatment is not routinely recommended because of prior reports of a high rate of perforation.

We used a standardized technique of polypectomy, using endoscopic looping to resect large colonic lipomas in 8 patients and followed their clinical outcomes.

The mean lipoma size was 3.8+/-1.2 cm (range 2.5-6 cm). No patient developed bleeding or perforation. On follow-up (mean=13.5 months, range 2-29), there was one small residual lesion.

Colonic lipomas larger than 2 cm can be safely and efficaciously removed using endoloop assisted polypectomy technique.