Laparo-endoscopic resection for extensive and inaccessible XXXX : a feasible and safe procedure.

@entity1 @entity1127 @entity1586
INTRODUCTION: Polypectomy at colonoscopy may be difficult or dangerous. In such instances colonic resection may be indicated. Novel combined laparoscopic-endoscopic procedures have the potential to allow safe extensive extramucosal resection, thus avoiding resection. Laparoscopic colon mobilisation provides a more favourable orientation for endoscopic mucosal resection and facilitates identification of possible perforation sites with immediate laparoscopic repair or resection if necessary. This study aimed to assess the efficacy and safety of laparo-endoscopic resection (LER) of @entity1586 . @entity1 AND METHODS: Data were collected prospectively on consecutive @entity1 undergoing LER. The mode of presentation, referral pattern, lesion site and size, hospital stay, procedural details, complications, histology and further treatment were recorded. RESULTS: A total of 13 @entity1 underwent attempted LER (16 @entity1127 in total) and this was completed for 10, with a median hospital stay of 2 days. Five @entity1127 were removed whole and eight piecemeal. Excision was clinically complete in all cases. Three procedures were converted to colonic resection. One lesion appeared malignant, indicating a conversion to laparoscopic right hemicolectomy. Two @entity1127 were not amenable to LER and resection was performed. One @entity1 underwent subsequent colonic resection based on the histological findings. There were no perforations or serious complications. CONCLUSIONS: LER is a safe and effective treatment for large and inaccessible @entity1586 that would otherwise be treated by colonic resection.
