Miguel A Hernandez, MD, Morris E Franklin, MD, FACS, Zanndor Del Real, MD, Guillermo Peralta, MD. Texas Endosurgery Institute.
Background: Colonoscopy is widely used to remove benign polyps. However, a variety of ‘‘difficult polyps’’ are not accessible for colonoscopy removal because of their size, broad base, or difficult location (impossible to see the polyp’s base, polyps behind mucosal folds or in tortuous colonic segments). The aim of the study was to evaluate the long-term follow-up and oncologic safety of laparoscopically monitored colonoscopic polypectomy (LMCP).
Methods: From May 1990 to September 2013, all the patients undergoing LMCP were analyzed and prospectively followed with colonoscopy studies at 6 months, 1 year, and every year thereafter.
Results: A total of 320 polyps were removed in 270 patients: 168 men (52.6%) and 152 women (47.4%). The mean age was 74.7 years (range 46–99 years). During a mean follow-up of 63.37 months (range 6–196 months) and median follow- up of 65 months, there has been no recurrence.
Conclusions: Long-term follow-up demonstrated that a combined endoscopic-laparoscopic approach is safe and effective. Malignant lesions identified during LMCP can be treated laparoscopically during the same operation, avoiding the need of a second procedure, with good long-term oncologic outcome.