title: [Surgical treatment for endoscopically unresectable polyps of colon and rectum].
abstract: OBJECTIVE
  To explore the characteristics and risks of cancer in endoscopically unresectable polyps and compare the surgical outcomes of different operations.
  
  
  METHODS
  A retrospective review of 40 patients undergoing surgical operations for polyps unresectable at colonoscopy between August 2006 and July 2012 from Department of Gastrointestinal Surgery was performed. The follow-up period was 3 to 72 months (median: 24.5 months).
  
  
  RESULTS
  The rate of endoscopically unresectable polyps with invasive cancer was 67.5% (27/40). And it was significantly influenced by patient age and number of polyps (both P < 0.01). Perioperative volume of blood loss ((86 ± 58) ml vs (44 ± 32) ml, P = 0.0066), time to first flatus ((2.7 ± 1.3) d vs (1.7 ± 0.6) d, P = 0.0018), incidence of complication (2 cases vs 0, P = 0.0365) and hospital stay ((11.2 ± 1.0) d vs (15.0 ± 5.0) d, P = 0.0164) were significantly different between open colectomy and laparoscopic group. And the long-term survival outcomes were similar in both groups (90.9% (10/11) vs 100.0% (27/27), 90.9% (10/11) vs 96.3% (26/27), both P > 0.05).
  
  
  CONCLUSIONS
  Endoscopically unresectable polyps of colon and rectum have high malignancy rate. Polyps in elderly patients and multiple polyps are more likely to develop invasive cancer. Long-term outcomes are similar between open colectomy and laparoscopic colectomy groups, but laparoscopic group has better short-term outcomes. For endoscopically unresectable polyps, laparoscopic colectomy may be the first choice.
authors.affiliation: Department of Gastrointestinal Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Jian-pei
authors.initials: JP
authors.lastname: Liu
authors.forename: Pin-jie
authors.initials: PJ
authors.lastname: Huang
authors.forename: Tu-feng
authors.initials: TF
authors.lastname: Chen
authors.forename: Zong-heng
authors.initials: ZH
authors.lastname: Zheng
authors.forename: Hong-bo
authors.initials: HB
authors.lastname: Wei
mesh_terms: D000368:Aged; D003111:Colonic Polyps / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome