Related Experiment Videos
[Colonic polyps considered unresectable by endoscopy. Removal by combinations of laparoscopy and endoscopy in 65
1Département Médico-Chirurgical de Pathologie Digestive, Institut Montsouris-Porte de Choisy, Paris.
Objective:
To determine to what extent segmental colectomy could be avoided in patients with polyps though to be endoscopically unresectable by using combination laparoscopy and endoscopy.
Methods:
Sixty-five patients referred for colonic polyps though to be unresectably by conventional endoscopy were studied. After analysis of the endoscopic findings, endoscopy was performed in a medicosurgical unit when possible, otherwise a surgical procedure was performed consisting of laparoscopy followed by colonoscopy. Therapeutic strategy depended on laparoscopic and endoscopic findings.
Results:
Segmental colectomy was avoided in 44 patients (67.7%). Among them, 20 were treated by simple endoscopic polyp removal, 12 by laparoscopy-assisted colonoscopic polypectomy, 9 by laparoscopic wedge colonic resection and 3 by colotomy after colonic exteriorization and polyp resection. Laparoscopic or laparoscopy-assisted segmental colectomy was performed in 16. Segmental colectomy by laparotomy was necessary in 5. No complication occurred.
Conclusion:
Segmental colectomy for unresectable colonic polyps could be avoided in more than half of the patients using laparoscopy and colonoscopy combinations.