Franklin Morris E, Portillo Guillermo
Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite 1, San Antonio, TX 78222, USA.
World J Surg. 2009 Jun;33(6):1306-9. doi: 10.1007/s00268-009-9967-8.
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).
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.
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.
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.
结肠镜检查广泛用于切除良性息肉。然而，由于各种“困难息肉”的大小、广基或位置困难（无法看到息肉基部、位于黏膜皱襞后方或在迂曲的结肠段），结肠镜下无法切除。本研究的目的是评估腹腔镜监测下结肠镜息肉切除术（LMCP）的长期随访情况及肿瘤学安全性。
对1990年5月至2008年1月期间所有接受LMCP的患者进行分析，并在术后6个月、1年及此后每年进行结肠镜检查进行前瞻性随访。
160例患者共切除209枚息肉，其中男性82例（51%），女性78例（49%）。平均年龄74.7岁（范围46 - 99岁）。平均随访63.37个月（范围6 - 196个月），中位随访65个月，无复发。
长期随访表明，内镜-腹腔镜联合方法安全有效。LMCP过程中发现的恶性病变可在同一次手术中通过腹腔镜治疗，避免二次手术的需要，长期肿瘤学结局良好。
