title: Laparoscopic colorectal surgery for colorectal polyps: single institution experience.
abstract: BACKGROUND
  Because of their difficult location or size, some polyps are impossible to remove with a flexible colonoscope and must be surgically removed. Laparoscopy is a great alternative.
  
  
  OBJECTIVE
  To assess outcomes of a laparoscopic approach for the management of difficult colorectal polyps.
  
  
  METHODS
  From 2006 to 2014, patients with polyps that could not be treated by endoscopy were included. Demographic data, histology of the biopsy, type of surgery, length of postoperative stay, complications and final pathology were reviewed prospectively.
  
  
  RESULTS
  Forty-two patients with a mean age of 64.9 ±8.4 underwent laparoscopic polypectomy. Laparoscopic mobilization of the colonic segment and colotomy with removal of the polyp was performed for 12 (28.6%) polyps. Laparoscopic segmental bowel resection was performed in 30 (71.4%) cases: anterior rectal resection with partial total mesorectal excision in 12 (28.6%), left hemicolectomy in 7 (16.6%), sigmoid resection in 6 (14.3%), ileocecal resection in 2 (4.76%), resection of transverse colon in 2 (4.76%) and sigmoid resection with transanal retrieval of specimen in 1 (2.38%). Mean postoperative hospital stay was 5.9 ±2.6 days. There were 4 complications (9.5%). All patients recovered after conservative treatment. Mean polyp size was 3.6 ±2.2 cm. Final pathology revealed polyps (n = 2), tubular adenoma (n = 6), tubulovillous adenoma (n = 20), carcinoma in situ (n = 10) and invasive cancer (n = 4). Two of these patients underwent laparoscopic left hemicolectomies 14 and 10 days after laparoscopic colotomy and polypectomy.
  
  
  CONCLUSIONS
  For the management of endoscopically unresectable polyps, laparoscopic polypectomy is currently the technique of choice.
authors.affiliation: Department of Abdominal and General Surgery and Oncology, Center of Surgical Oncology, Vilnius, Lithuania.
authors.forename: Audrius
authors.initials: A
authors.lastname: Dulskas
authors.affiliation: Center of Surgical Oncology, National Cancer Institute, Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Vilnius, Lithuania.
authors.forename: Narimantas Evaldas
authors.initials: NE
authors.lastname: Samalavicius
authors.affiliation: Department of Surgery, Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences, Nepal.
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Gupta
authors.affiliation: Department of Cardiovascular Disease, Center of Reconstructive and Endovascular Surgery, Vilnius, Lithuania.
authors.forename: Vaidotas
authors.initials: V
authors.lastname: Zabulis
keywords: colectomy; colorectal polyp; hand-assisted laparoscopic surgery; laparoscopic surgery