title: Colonic lipomas. Three surgical techniques for three different clinical cases.
abstract: Colonic lipomas larger than 2 cm in diameter are likely to be symptomatic. In some cases a complication is the first clinical sign. Massive lower intestinal bleeding or obstruction, acute bleeding, prolapse or perforation or, rarely, acute intussusception with intestinal obstruction require urgent surgery. Diagnosis is often made following colonoscopy, which can also have a therapeutic role. Imaging procedures such as CT has a secondary role. Patients with small asymptomatic colonic lipomas need regular follow up. For larger (diameter > 2 cm) and/or symptomatic lipomas, resection should be considered, although the choice between endoscopic or surgical resection remains controversial. We believe that even lipomas > 2 cm can safely be removed by endoscopic resection. If surgery is indicated, we consider laparoscopy to be the ideal approach in all patients for whom minimally invasive surgery is not contraindicated.
authors.affiliation: Department of Emergency and Organ Transplantation, Aldo Moro University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pezzolla
authors.forename: S
authors.initials: S
authors.lastname: Lattarulo
authors.forename: O
authors.initials: O
authors.lastname: Caputi
authors.forename: I
authors.initials: I
authors.lastname: Ugenti
authors.forename: G
authors.initials: G
authors.lastname: Fabiano
authors.forename: D
authors.initials: D
authors.lastname: Piscitelli
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007080:Ileocecal Valve / Q000473:pathology / Q000601:surgery*; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D008067:Lipoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012811:Sigmoid Neoplasms / Q000601:surgery; D016896:Treatment Outcome; D020535:Video-Assisted Surgery