Laparoscopic-assisted Polypectomy: A Promising Minimally-invasive Solution for Endoscopically Irresectable Polyps in...

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Oncology

Background:

• Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS) commonly present with small and large bowel polyps in children.
• Endoscopic or digital palpation methods may be insufficient or carry risks for certain polyp locations or sizes.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic-assisted polypectomy technique (LAPT) in a pediatric tertiary center.
• To report the center's experience with LAPT for managing complex intestinal polyps in children.

Main Methods:

• A prospective review of pediatric patients (<18 years) who underwent LAPT over a 13-year period.
• Data collection included demographics, diagnosis, operative details, histopathology, complications, and follow-up.
• Exclusion criteria included patients over 18 years or those who had undergone endoscopic polypectomy.

Main Results:

• Seventeen pediatric patients (median age 12 years) underwent 19 LAPT procedures between 2011 and 2024.
• Fourteen patients had PJS, and 3 had JPS; polyps were unsuitable for standard endoscopic removal due to size, location, or perforation risk.
• LAPT was successful in all cases, with no conversions to open surgery, a median hospital stay of 5 days, and no late complications.

Conclusions:

• Laparoscopic-assisted polypectomy (LAPT) is an effective and safe surgical option for excising intestinal polyps in children, particularly those with PJS and JPS.
• LAPT offers a viable alternative to endoscopic methods for polyps with a higher risk of perforation, eliminating the need for concurrent endoscopy or digital palpation.