Laparoscopic colectomy in the management of large, sessile, transformed colorectal polyps.
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.
Nassiopoulos
Konstantinos
K
Department of General Surgery, Hopital Cantonal Friburg, Switzerland.
Pavlidis
Theodoros E
TE
Menenakos
Evangelos
E
Chanson
Cristian
C
Zografos
George
G
Petropoulos
Panajotis
P
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*