title: Laparoscopic colectomy in the management of large, sessile, transformed colorectal polyps.
abstract: BACKGROUND
  Colonic polyps are usually removed endoscopically. Surgical intervention is reserved for large, inaccessible colorectal polyps that have underdone malignant transformation. Laparoscopic management of colonic polyps has gained a well-defined role.
  
  
  METHODS
  Since 1993, 650 laparoscopic colectomies have been performed in our department. Twenty-eight patients with large, sessile, polyps that have undergone malignant transformation underwent elective laparoscopic colectomy. Operative procedures included 14 sigmoidectomies, 10 low anterior recto-sigmoid resections, 3 right colectomies, and 1 left colectomy. Central ligation of vessels and lymph node dissection were preformed in all patients.
  
  
  RESULTS
  The main outcome measures include conversion rate (11%), morbidity (11%), and mortality (3.5%). The mean return of bowel function was 3.1 days, liquid intake 1.4 days, solid food intake 2.5 days, and mean hospital stay 8 days. The mean specimen length was 23 cm, and the mean number of retrieved lymph nodes was 15. Malignancy according to Dukes classification was in situ, n=4; A, n=15; B, n=4; C, n=4; and D, n=1. During follow-up, 2 patients developed liver metastases.
  
  
  CONCLUSIONS
  Laparoscopic colectomy is a technically feasible and effective method for treating large colorectal polyps that have undergone malignant transformation.
authors.affiliation: Department of General Surgery, Hopital Cantonal Friburg, Switzerland.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Nassiopoulos
authors.forename: Theodoros E
authors.initials: TE
authors.lastname: Pavlidis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Menenakos
authors.forename: Cristian
authors.initials: C
authors.lastname: Chanson
authors.forename: George
authors.initials: G
authors.lastname: Zografos
authors.forename: Panajotis
authors.initials: P
authors.lastname: Petropoulos
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods*; D003111:Colonic Polyps / Q000601:surgery*; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*