title: Laparoscopic colectomy for colonic polyps.
abstract: BACKGROUND
  Benign colonic polyps not amenable to colonoscopic resection or those containing carcinoma require surgical excision. Traditionally, formal colectomy with clearance of the lymphatic basin has been performed. The aim of this study was to review our experience with the laparoscopic approach for retrieval of colonic polyps with specific emphasis on safety, feasibility, and tumor localization.
  
  
  METHODS
  Retrospective chart review of all patients who underwent laparoscopic colectomy for colonic polyps was performed. Initial colonoscopic biopsies were compared with the postoperative pathology report of the resected specimen.
  
  
  RESULTS
  Forty-nine patients (22 males, 27 males, mean age 66 years) underwent laparoscopic colectomy for colonic polyps. Indications for surgery were presumably benign polyps in 38 patients, and superficial carcinoma in a polyp, diagnosed by colonoscopy, in 11; twenty-three patients underwent preoperative localization procedures. In 19% of patients who did not have preoperative localization, difficulties locating the polyp were encountered during surgery, requiring intraoperative endoscopy or conversion to laparotomy. In 7 of the 38 patients with presumably benign lesion, colon cancer was diagnosed in the colectomy specimen. None of the 18 patients who had cancerous lesions had any positive lymph nodes.
  
  
  CONCLUSIONS
  Laparoscopic surgery for the treatment of colonic polyps seems to be feasible and safe, with a low complication rate. Tumor localization is crucial for adequate resection. Although one-fifth of presumably benign polyps harbored cancer, none of these patients had positive lymph nodes. These preliminary results may question the need for radical lymph node clearance in these patients.
authors.affiliation: Department of Surgery and Transplantation, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Hashomer, Isreal. ozmora@post.tau.ac.i
authors.forename: Oded
authors.initials: O
authors.lastname: Zmora
authors.forename: Barak
authors.initials: B
authors.lastname: Benjamin
authors.forename: Avi
authors.initials: A
authors.lastname: Reshef
authors.forename: David
authors.initials: D
authors.lastname: Neufeld
authors.forename: Danny
authors.initials: D
authors.lastname: Rosin
authors.forename: Ehud
authors.initials: E
authors.lastname: Klein
authors.forename: Amram
authors.initials: A
authors.lastname: Ayalon
authors.forename: Baruch
authors.initials: B
authors.lastname: Shpitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome