Laparoscopic-assisted coloscopic polypectomy

Prohm, P.; Weber, Jörg; Bönner, Christoph

doi:10.1007/bf02234579

Cited by 48 publications

(32 citation statements)

References 8 publications

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“…Bei der alleinigen koloskopischen Polypektomie wird hierbei die Möglichkeit der operativen Mobilisation des Kolons zur besseren Exposition für den Endoskopiker und gleichzeitigen laparoskopischen Überwa-chung und Versorgung eventueller Perforationen eröffnet [20,21,22] . 1, 2).…”

Section: Rendezvous-verfahrenunclassified

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Rüth

Spatz

Anthuber

2011

Chirurg

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The knowledge that due to the adenoma-cancer sequence polyps will develop sooner or later into invasive cancer demands the complete removal of colorectal polyps. The majority of polyps can be endoscopically removed. The indications for surgical removal of polyps are a previous incomplete endoscopic resection, location not amenable to endoscopic removal and lesions which are macroscopically highly suspicious for malignancy and cannot be detached by submucosal saline injection. If a surgical approach is indicated minimally invasive surgery in the hands of an experienced laparoscopic surgeon is a suitable option. Adenomas suspicious for malignancy in the lower two thirds of the rectum should not be treated by time-consuming endoscopic submucosal dissection (ESD) and can be quickly and safely removed transanally, conventionally or by transanal endoscopic microsurgery (TEM) by a full thickness én bloc resection. This allows the pathologist to determine the depth of invasion and the completeness of resection in terms of the circumferential margin and a definitive radical surgical approach is only necessary in high risk situations.

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Section: Rendezvous-verfahrenunclassified

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Rüth

Spatz

Anthuber

2011

Chirurg

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“…Prohm et al described a series of six patients undergoing endoscopic polypectomy with laparoscopic mobilisation. 4 The postoperative stay had a median of 2.5 days. Hensman et al reported on a series of six polyps between 3cm and 7cm in size removed via endoscopy with laparoscopy and colon mobilisation if required.…”

Section: Wood Lord Wheeler Borley Laparo-endoscopic Resection For Extmentioning

confidence: 99%

“…3 other reports have described the technique for small series of between two and twelve polyps. 4,5,6,7,8 laparoscopic colonic mobilisation has the potential to orientate the colon to a more favourable and stable position, and to facilitate intraoperative EMR via the colonoscope. It also allows identification of sites of potential iatrogenic bowel injury, with the option of immediate laparoscopic repair.…”

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confidence: 99%

Laparo-endoscopic resection for extensive and inaccessible colorectal polyps: a feasible and safe procedure

Wood

Lord

Wheeler

et al. 2011

annals

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INTRODUCTION Polypectomy at colonoscopy may be difficult or dangerous. In such instances colonic resection may be indicated. Novel combined laparoscopic-endoscopic procedures have the potential to allow safe extensive extramucosal resection, thus avoiding resection. Laparoscopic colon mobilisation provides a more favourable orientation for endoscopic mucosal resection and facilitates identification of possible perforation sites with immediate laparoscopic repair or resection if necessary. This study aimed to assess the efficacy and safety of laparo-endoscopic resection (LER) of colonic polyps. PATIENTS AND METHODS Data were collected prospectively on consecutive patients undergoing LER. The mode of presentation, referral pattern, lesion site and size, hospital stay, procedural details, complications, histology and further treatment were recorded. RESULTS A total of 13 patients underwent attempted LER (16 polyps in total) and this was completed for 10, with a median hospital stay of 2 days. Five polyps were removed whole and eight piecemeal. Excision was clinically complete in all cases. Three procedures were converted to colonic resection. One lesion appeared malignant, indicating a conversion to laparoscopic right hemicolectomy. Two polyps were not amenable to LER and resection was performed. One patient underwent subsequent colonic resection based on the histological findings. There were no perforations or serious complications. CONCLUSIONS LER is a safe and effective treatment for large and inaccessible colonic polyps that would otherwise be treated by colonic resection.

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“…Indikationsspektrum und Problematik dieser Verfahren entsprechen denen der rein endoskopischen Technik. Eine valide Beurteilung dieser Methode bezüglich der onkologischen Ergebnisse ist aufgrund der limitierten Anzahl von verwertbaren Untersuchungen zu dieser Thematik derzeit nur schwer möglich [24,27,10].…”

Section: Lokale Chirurgische Resektionenunclassified

R1-Resektion im Bereich des unteren Gastrointestinaltrakts

Schlag

2007

Chirurg

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Incomplete resection (R1) and local recurrence of colorectal cancer continue to be a significant surgical problem. Radical resection of bowel and lymph node bassin are clearly necessary after incomplete endoscopic resection or local surgical excision. However, the situation is more difficult after previous conventional surgery. Anastomotic recurrence following resection and lymph nodal recurrence can often precede curative reresection. Locoregional lymph node metastases due to incomplete surgical clearance of the lymphatic drainage of colonic cancer may also be cured by radical reresection. Despite application of neoadjuvant therapy, integration of modern surgical concepts such as the circumferential resection margin and advances in surgical technique, R1 resection of rectal cancer remains a major problem. Although primary surgical therapy may be considered in selected cases, this situation will require multimodal therapy in most instances.

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Laparoscopic-assisted coloscopic polypectomy

Abstract: The laparoscopic-assisted polypectomy is a safe method to remove even complicated polyps in anatomically unfavorable locations.

Cited by 48 publications

References 8 publications

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Kolorektale Adenome: Pro konventionelle/laparoskopische Resektion

Laparo-endoscopic resection for extensive and inaccessible colorectal polyps: a feasible and safe procedure

R1-Resektion im Bereich des unteren Gastrointestinaltrakts

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