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Session: ePoster Monitor 4-Other Neoplasia and Endoscopy and Pelvic Floor

eP309 - Laparoscopically Assisted Colonoscopic Polypectomy : A 7-year Retrospective Analysis

Sunday, June 2, 2024
10:21 AM – 10:26 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Giancarlo Sticca, MD

    General Surgery Resident
    University of Montreal
    University of Montreal
    montreal, QC, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • JT

    Jean-François Tremblay, MD

    Clinical assistant professor of surgery
    University of Montreal
    montreal, Quebec, Canada

    Disclosure information not submitted.

    • Senior Author(s)

  • MH

    Margaret Henri, MD FRSCS FACS

    Clinical associate professor of surgery
    Maisonneuve-Rosemont Hospital, University of Montreal
    montreal, Quebec, Canada

    Disclosure information not submitted.

    • Author(s)

  • MP

    Madeleine Poirier, MD

    Clinical associate professor of surgery
    Maisonneuve-Rosemont Hospital
    montreal, Quebec, Canada

    Disclosure information not submitted.

Purpose/Background: Colorectal cancer is the third most common cancer worldwide. Prevention and treatment is largely based on the identification and removal of colorectal polyps through colonoscopy. Despite advanced colonoscopic techniques, 10-15% of polyps remain endoscopically unresectable. In these patients, laparoscopically assisted colonoscopic polypectomy (LACP) is a minimally invasive alternative to surgical segmental resection, which can be associated with significant morbidity and mortality. The purpose of this study was to determine the added value of this procedure in terms of complete polypectomy, perioperative complications and local recurrence at one year or more of endoscopic follow up. Secondary endpoints included procedural length and postoperative length of stay (LOS).Methods/Interventions: The study was conducted at Maisonneuve-Rosemont Hospital in Montreal. A retrospective analysis of all consecutive patients undergoing LACP between September 2017 and September 2023 was conducted. All patients with benign polyps at initial biopsy deemed endoscopically unresectable by a colorectal surgeon or a gastroenterologist were included.Results/Outcomes: Fifty-two patients were scheduled for a LACP. Conversion to a laparoscopic segmental resection was decided in 18 patients (34.6%) due to large size, difficult localization or suspicion of malignancy. Thus, 34 patients ultimately underwent LACP. Complete endoscopic removal of the polyp was performed in 33 patients (97.1%). Mean procedure time was 77 ± 2 minutes. 94.1% of patients experienced no perioperative complications. Colonic perforation occurred in 2 patients (5.9%). Laparoscopic repair was performed intraoperatively and the two patients subsequently evolved uneventfully in the postoperative period. No intra-luminal or intra-abdominal hemorrhage occurred intra or post-operatively. Thirty-one patients (81.6%) had a day-surgery. Operative pathology results showed invasive adenocarcinoma in 1 patient (2.9%). Of the 34 patients that underwent LACP, 22 patients had a follow-up colonoscopy at a mean time of 15.2 ± 10 months. 16 patients (72.7%) demonstrated no recurrence and 6 patients (27.3%) had recurrence at the site of the previously resected polyp. The other 12 patients either refused follow-up (3), were lost to follow-up (3), passed away from other causes (3) or are still awaiting their follow-up (2).Conclusion/

Discussion: LACP demonstrated high operative success, low intraoperative risk and short procedural time. LACP results in short postoperative LOS and allows most patients to return home on the same day as their operation. For patients for which follow-up endoscopy could be performed, LACP demonstrated low recurrence rates. LACP is a minimally invasive procedure which may reduce the number of patients needing formal colonic resection for complex polyps.