Objective: To determine to what extent segmental colectomy could be avoided in patients with polyps though to be endoscopically unresectable by using combination laparoscopy and endoscopy.
Methods: Sixty-five patients referred for colonic polyps though to be unresectably by conventional endoscopy were studied. After analysis of the endoscopic findings, endoscopy was performed in a medicosurgical unit when possible, otherwise a surgical procedure was performed consisting of laparoscopy followed by colonoscopy. Therapeutic strategy depended on laparoscopic and endoscopic findings.
Results: Segmental colectomy was avoided in 44 patients (67.7%). Among them, 20 were treated by simple endoscopic polyp removal, 12 by laparoscopy-assisted colonoscopic polypectomy, 9 by laparoscopic wedge colonic resection and 3 by colotomy after colonic exteriorization and polyp resection. Laparoscopic or laparoscopy-assisted segmental colectomy was performed in 16. Segmental colectomy by laparotomy was necessary in 5. No complication occurred.
Conclusion: Segmental colectomy for unresectable colonic polyps could be avoided in more than half of the patients using laparoscopy and colonoscopy combinations.