Laparoscopic monitored colonoscopic polypectomy: long-term follow-up.

BACKGROUND

Colonoscopy is widely used to remove benign polyps. However, a variety of "difficult polyps" are not accessible for colonoscopic 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 January 2008, all the patients undergoing LMCP were analyzed and prospectively followed with colonoscopic studies at 6 months, 1 year, and every year thereafter.

RESULTS

A total of 209 polyps were removed in 160 patients: 82 men (51%) and 78 women (49%). 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.