Laparoscopic Colon Resection of Benign Polyps High Grade Dysplasia on Endoscopic Biopsy and Polyp Location Predict Risk of Cancer

被引:11
|
作者
Blumberg, David [1 ]
机构
[1] Univ Pittsburgh, Med Ctr & Bandaid Surg, Dept Surg, Pittsburgh, PA 15232 USA
来源
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES | 2009年 / 19卷 / 03期
关键词
laparoscopic colectomy; colon polyps; prognostic factors; malignancy; ASSISTED COLECTOMY; MALIGNANT-DISEASE; LEARNING-CURVE; ADENOMAS;
D O I
10.1097/SLE.0b013e3181a6e494
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: To ensure that an oncologic resection is not compromised, laparoscopic surgery is not recommended for colon cancer patients during the learning curve. Although patients with colon polyps are frequently selected as "learning cases," several studies have found a high incidence of occult cancers in this subset of patients questioning the safety of this approach. A retrospective review was performed of laparoscopic resections for colonic polyps to determine the incidence of occult cancer and, clinical and pathologic factors predictive of cancer. Methods and Results: From January 2004 and September 2007, 44 colectomies were performed for colonic polyps. Data from a prospective database examined and Supplemented by pathology reports. Of 44 patients operative conversion was 5% with a 4-day median length of stay, a morbidity of 20% with no mortalities. All patients had clear surgical margins with a median of 12 lymph nodes detected. An occult cancer was detected in 6 of 44 cases (14%). High-grade dysplasia oil endoscopic biopsy and polyp location distal to the splenic flexure was associated with a significantly (P < 0.05) increased risk of cancer. Forty-three percent of cancers were detected in polyps with high-grade dysplasia compared with 8% of polyps without dysplasia oil biopsy. Polyps distal to the splenic flexure had a 43% rate of occult cancers detected compared with 8% in polyps proximal to the splenic flexure. Conclusions: Colonic polyps with high-grade dysplasia on endoscopic biopsy and polyps located distal to the splenic flexure are associated with the highest risk of cancer and may not be appropriate cases during the learning curve.
引用
收藏
页码:255 / 257
页数:3
相关论文
共 50 条
  • [41] Correlation between endoscopic forceps biopsies and endoscopic mucosal resection with endoscopic ultrasound in patients with Barrett’s esophagus with high-grade dysplasia and early cancer
    Prashanthi N. Thota
    Alaa Sada
    Madhusudhan R. Sanaka
    Sunguk Jang
    Rocio Lopez
    John R. Goldblum
    Xiuli Liu
    John A. Dumot
    John Vargo
    Gregory Zuccarro
    Surgical Endoscopy, 2017, 31 : 1336 - 1341
  • [42] Correlation between endoscopic forceps biopsies and endoscopic mucosal resection with endoscopic ultrasound in patients with Barrett's esophagus with high-grade dysplasia and early cancer
    Thota, Prashanthi N.
    Sada, Alaa
    Sanaka, Madhusudhan R.
    Jang, Sunguk
    Lopez, Rocio
    Goldblum, John R.
    Liu, Xiuli
    Dumot, John A.
    Vargo, John
    Zuccarro, Gregory
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2017, 31 (03): : 1336 - 1341
  • [43] Synchronous Three Gastric Fundic Gland Polyps with Low-grade Dysplasia Treated with Endoscopic Mucosal Resection after Being Diagnosed to Be Tubular Adenocarcinoma Based on a Biopsy Specimen
    Shibukawa, Narihiro
    Wakahara, Yuhei
    Ouchi, Shohei
    Wakamatsu, Shuji
    Kaneko, Akira
    INTERNAL MEDICINE, 2019, 58 (13) : 1871 - 1875
  • [44] Lymphocyte Density in Barrett's Esophagus Biopsy Specimens Is Associated with Risk of Progression to High Grade Dysplasia or Cancer
    Wagner, Patrick L.
    Park, Hyun Young
    Omstead, Ashten
    Xiao, Kunhong
    Kochhar, Gursimran
    Lewis, Catherine
    Landau, Michael
    Stairs, Douglas
    Zaidi, Ali
    JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2024, 239 (05) : S449 - S450
  • [45] Endoscopic local therapy of high-grade dysplasia and early cancer in Barrett's esophagus. The significance of endoscopic mucosal resection, photodynamic therapy, and thermal techniques
    Gossner, L
    May, A
    Ell, C
    CHIRURGISCHE GASTROENTEROLOGIE, 2001, 17 (01): : 57 - 64
  • [46] Satisfactory long-term progress in patients treated by endoscopic mucosal resection for high-grade dysplasia or superficial squamous cell cancer of the esophagus
    Canard, J. -M.
    Rahmi, G.
    Palazzo, L.
    Landi, B.
    Maniere, T.
    Cellier, C.
    Jian, R.
    ACTA ENDOSCOPICA, 2011, 41 (04) : 193 - 199
  • [47] Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett's oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial
    van Vilsteren, Frederike G. I.
    Pouw, Roos E.
    Seewald, Stefan
    Herrero, Lorenza Alvarez
    Sondermeijer, Carine M. T.
    Visser, Mike
    ten Kate, Fiebo J. W.
    Teng, Karl C. Yu Kim
    Soehendra, Nib
    Roesch, Thomas
    Weusten, Bas L. A. M.
    Bergman, Jacques J. G. H. M.
    GUT, 2011, 60 (06) : 765 - 773
  • [48] Endoscopic resection of gastric low-grade dysplasia with high risk factors is associated with decreased advanced neoplasia: a single-center retrospective cohort study
    Lang Yang
    Xian-zong Ma
    Xin Wang
    Jun-feng Xu
    Heng Zhang
    Yu-rong Tao
    Na Li
    Hui Su
    Yu-qi He
    Jian-qiu Sheng
    Peng Jin
    Surgical Endoscopy, 2023, 37 : 4737 - 4747
  • [49] Frequency and Risk Factors of Esophageal Stricture After Endoscopic Mucosal Resection (EMR) for Barrett's Esophagus (BE) with High-Grade Dysplasia (HGD) or Adenocarcinoma (CA)
    Yen, Roy
    Dekovich, Alexander A.
    Chen, Yang K.
    Shah, Raj J.
    Brauer, Brian C.
    Ringold, Daniel A.
    Fukami, Norio
    GASTROINTESTINAL ENDOSCOPY, 2009, 69 (05) : AB342 - AB342
  • [50] Endoscopic resection of gastric low-grade dysplasia with high risk factors is associated with decreased advanced neoplasia: a single-center retrospective cohort study
    Yang, Lang
    Ma, Xian-zong
    Wang, Xin
    Xu, Jun-feng
    Zhang, Heng
    Tao, Yu-rong
    Li, Na
    Su, Hui
    He, Yu-qi
    Sheng, Jian-qiu
    Jin, Peng
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2023, 37 (06): : 4737 - 4747