Minilaparotomy approach for the resection of laterally spreading tumors of the colon.
OBJECTIVE
We report our experience of using the minimally invasive minilaparotomy approach to resect colonic laterally spreading tumors (LSTs) that could not be removed by colonoscopic snare polypectomy.


METHODS
We prospectively examined 17 patients who underwent a minilaparotomy, defined as an incision less than 7 cm long, between 1997 and 2001, for a collective 19 colonic LSTs.


RESULTS
Complete en bloc resection of the LSTs was successfully performed in all 17 patients. The resections included colotomy and polypectomy in four patients (four LSTs), limited colectomy in seven patients (nine LSTs), and colectomy with regional lymph node dissection in six patients (six LSTs). There was no mortality or morbidity. The mean +/- standard deviation (SD) length of the minilaparotomy was 6.7 (+/-0.8) cm, and the mean (+/-SD) operating time and blood loss were 139 (+/-39) min and 27 (+/-15) ml, respectively. Histology revealed 2 adenomas, 16 Tis carcinomas, and 1 T1 carcinoma. None of the patients had lymph node metastasis or positive resection margins. There have been no signs of tumor recurrence after a median follow-up period of 30.4 months.


CONCLUSIONS
The minilaparotomy approach is appropriate for resecting LSTs that cannot be removed by colonoscopic snare polypectomy, and provides a minimally invasive alternative to conventional laparotomy.
Nakagoe
Tohru
T
First Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Sawai
Terumitsu
T
Tsuji
Takashi
T
Tanaka
Kenji
K
Shibasaki
Shin-ichi
S
Hidaka
Shigekazu
S
Nanashima
Atsushi
A
Yamaguchi
Hiroyuki
H
Yasutake
Toru
T
D000236:Adenoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*