Limited Endoscopic-Assisted Wedge Resection for Excision of Colon Polyps.
BACKGROUND
Combined endoscopic laparoscopic surgical removal is used for polyps in the colon that are not suitable for endoscopic removal because of size, location, or scarring. However, the placement of a linear stapler can be challenging. Currently a wedge resection is mostly documented in the cecum or ascending colon.


OBJECTIVE
We report on our experience with limited endoscopy-assisted wedge resections in the entire colon.


METHODS
A retrospective study was performed.


METHODS
This was a single-center study.


METHODS
Eight patients were included between March 2015 and April 2016.


METHODS
The laparoscopic surgical technique consisted of placing a suture under endoscopic view through the base of the polyp into the lumen. Subsequently, traction was given on the suture to enable stapling of a wedge of the colon.


METHODS
Medical data were collected (ie, indication for referral for surgery, location and size of the polyp, duration of surgical procedure, length of hospital stay, and perioperative and postoperative complications). Operative time was defined as the total time of general anesthesia.


RESULTS
Eight patients, with a mean age of 74.5 years (range, 68.0-82.0 years), were treated. The main indications for laparoscopic resection were the size and difficult location of the polyp. There were no complications. Mean operative time was 132 minutes. Five patients were discharged the day after surgery, and the other 3 patients were admitted for a total of 2 days.


CONCLUSIONS
The study was limited by its small sample size.


CONCLUSIONS
Our study found that limited endoscopy-assisted wedge resection is a feasible and easy technique for the removal of colon polyps and residual adenomatous tissue in scars that are not accessible for endoscopic removal. Because of traction given on the suture through the base of the polyp, the linear stapler is easily used for wedge resections of polyps, even for those that are not in favorable positions.
1 Department of Gastroenterology and Hepatology, Isala, Zwolle, Netherlands 2 Department of Surgery, Isala, Zwolle, Netherlands.
Laura W
LW
Leicher
Wouter H
WH
de Vos Tot Nederveen Cappel
Henderik L
HL
van Westreenen
D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D013528:Surgical Staplers