title: Laparoscopic colorectal resection for benign polyps not suitable for endoscopic polypectomy.
abstract: OBJECTIVE
  Endoscopic polypectomy still remains the cornerstone of therapy for colorectal polyps and adenomas. However, if colorectal polyps are too large or not accessible for endoscopic ablation or cannot be removed without an increased risk for perforation, operative procedures are required. In such circumstances, laparoscopic resection represents a minimally invasive alternative.
  
  
  METHODS
  Between January 1993 and December 2004, more than 2,500 endoscopic polypectomies were performed at the Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Germany. In patients which could not be treated by endoscopic polypectomy due to size, location, and/or risk of complications, a laparoscopic colorectal resection was performed. All data were prospectively assessed in our "colorectal resection" database.
  
  
  RESULTS
  The database analysis revealed 58 patients with endoscopically not resectable colorectal polyps who underwent a laparoscopic colorectal resection (intend to treat). In 54 patients, the operative procedure could be finished by the laparoscopic approach (study population). The conversion rate was 6.9% (four of 58). An ileocolic resection was performed in 20 patients (37.0%), and 14 patients (25.9%) underwent an anterior rectal resection. A right colectomy was necessary in 12 patients (22.2%), and six patients (11.1%) underwent a sigmoid resection. In the remaining two patients, a left colectomy and a resection of the transverse colon were performed. Intra- and postoperative complications occurred in five patients (9.3%). Perioperative mortality was not registered. The histopathological work-up revealed benign disease in all cases.
  
  
  CONCLUSIONS
  Laparoscopic resection of colorectal polyps is a safe and minimally invasive technique for the management of benign colorectal tumors. Thus, the laparoscopic approach to endoscopically not resectable polyps enriches the therapeutic spectrum.
authors.affiliation: Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Hauenschild
authors.forename: Franz Georg
authors.initials: FG
authors.lastname: Bader
authors.forename: Tilman
authors.initials: T
authors.lastname: Laubert
authors.forename: Ralf
authors.initials: R
authors.lastname: Czymek
authors.forename: Philipp
authors.initials: P
authors.lastname: Hildebrand
authors.forename: Uwe Johannes
authors.initials: UJ
authors.lastname: Roblick
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.forename: Lutz
authors.initials: L
authors.lastname: Mirow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000473:pathology* / Q000601:surgery*; D003107:Colorectal Surgery; D003710:Demography; D004724:Endoscopy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology