Garrett Kelly A, Lee Sang W
Division of Colon and Rectal Surgery, Department of Surgery, NY Presbyterian Hospital, Weill Cornell Medical College, New York, New York.
Clin Colon Rectal Surg. 2015 Sep;28(3):140-5. doi: 10.1055/s-0035-1555005.
Benign colon polyps are best treated endoscopically. Colon polyps that are not amenable for endoscopic removals either because they are too large or situated in anatomically difficult locations can pose a clinical dilemma. Traditionally the most common recommendation for these patients has been to offer a colon resection. Although the laparoscopic approach has improved short-term outcomes, morbidities associated with bowel resection are still significant. We may be over treating majority of these patients because of the remote possibility that these polyps may be harboring a cancer. A combined approach using both laparoscopy and colonoscopy (combined endoscopic and laparoscopic surgery) has been described as an alternative to bowel resection in select patients with polyps that cannot be removed endoscopically. Polyp removal using this combined approach may be an effective alternative in select patients.
良性结肠息肉最好通过内镜治疗。由于体积过大或位于解剖位置困难的部位而无法通过内镜切除的结肠息肉会带来临床难题。传统上,针对这些患者最常见的建议是进行结肠切除术。尽管腹腔镜手术方法改善了短期疗效,但与肠切除术相关的发病率仍然很高。由于这些息肉可能隐藏癌症的可能性极小,我们可能过度治疗了这些患者中的大多数。对于某些无法通过内镜切除息肉的患者,一种结合腹腔镜和结肠镜检查的联合方法(内镜与腹腔镜联合手术)已被描述为肠切除术的替代方案。在某些患者中,使用这种联合方法切除息肉可能是一种有效的替代方案。