Background Need for colon sparing interventions for premalignant lesions not amenable to conventional endoscopic exci- sion has stimulated interest in advanced endoscopic approaches. The aim of this study was to report a single institution’s experience with these techniques. Methods A retrospective review was conducted of a prospectively collected database of all patients referred between 2011 and 2015 for colorectal resection of benign appearing deemed endoscopically unresectable by conventional endoscopic techniques. Patients were counseled for endoscopic submucosal dissection (ESD) with possible combined endoscopic– laparoscopic surgery (CELS) or alternatively colorectal resection if unable to resect endoscopically or suspicion for cancer. Lesion characteristic, resection rate, complications, and outcomes were evaluated. Results 110 patients were analyzed [mean age 64 years, female gender 55 (50%), median body mass index 29.4 kg/m ]. Indications for interventions were large polyp median endoscopic size 3 cm (range 1.5–6.5) and/or difficult location [cecum (34.9%), ascending colon (22.7%), transverse colon (14.5%), hepatic flexure (11.8%), descending colon (6.3%), sigmoid colon (3.6%), rectum (3.6%), and splenic flexure (2.6%)]. Lesion morphology was sessile (N = 98, 93%) and pedunculated (N = 12, 7%). Successful endoscopic resection rate was 88.2% (N = 97): ESD in 69 patients and CELS in 28 patients. Com- plication rate
Surgical Endoscopy – Springer Journals
Published: Jan 23, 2018
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