title: Endoscopic ligation ("Loop-And-Let-Go") is effective treatment for large colonic lipomas: a prospective validation study.
abstract: BACKGROUND
  Colonic lipomas (CL) are rare benign adipose tumours usually found incidentally during colonoscopy. Endoscopic resection of symptomatic large CL remains controversial, since significant rates of perforation have been reported. In recent years, a novel technique for removal of large CL has been described, consisting of looping and ligating the lipoma with a nylon snare. The aim of our study was to evaluate the safety and efficacy of the "loop and let go" technique for large colon lipomas in a large case series.
  
  
  METHODS
  Consecutive patients referred to our institution for colonoscopy were eligible for the study. The diagnosis of CL was confirmed endoscopically by "pillow" and "naked fat" signs. Following diagnosis, lipomas were looped and ligated by endoloop. Follow-up colonoscopies were scheduled at 1- and 3-months interval.
  
  
  RESULTS
  A total of 11 patients with large CL were enrolled in study. The indications for the colonoscopy included altered bowel habits (7 patients, 64%), screening for colorectal neoplasm (3 pts, 27%) and lower gastrointestinal bleeding (1 pts, 9%). The median lesion size was 3 cm (range 2,5-6 cm). Lesions were located at the hepatic flexure in 4 patients (36%), cecum and ascending colon (4 pts, 36%), rectosigmoid (2 pts, 18%) and transverse colon (1 pts, 9%). There were no immediate and late complications. On follow-up (median follow-up time 11.9 months, range 8-24), there was one small residual lipoma (<1 cm).
  
  
  CONCLUSIONS
  The results of this study confirm that "loop-and-let-go" technique is safe and efficacious treatment of large colonic lipomas.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb, Croatia. hrvoje.ivekovic@gmail.com.
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Ivekovic
authors.forename: Nadan
authors.initials: N
authors.lastname: Rustemovic
authors.forename: Tomislav
authors.initials: T
authors.lastname: Brkic
authors.forename: Rajko
authors.initials: R
authors.lastname: Ostojic
authors.forename: Klaus
authors.initials: K
authors.lastname: Monkemuller
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008026:Ligation / Q000379:methods; D008067:Lipoma / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome