ABSTRACT
Objective To explore the advantages and disadvantages of laparoscopic combined with colonoscopic surgery (double endoscope surgery) and open surgery in the treatment of special types of colorectal polyps. Methods The clinical data of 62 patients with special types of colorectal polyps (wide base sessile, special parts or suspected cancerous, endoscopic resection difficult or high risk) were retrospectively analyzed. Among them, 42 patients underwent double endoscope surgery (double endoscope group), and 20 patients underwent open surgery (open group). The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate were compared between 2 groups. Results All the patients had successful resection of the polyps, and there were no operative deaths. There was no conversion to open surgery in double endoscope group. Two patients in the open group were unable to locate the lesion by the tactile sensation of the hand and then succeeded in locating by intraoperative colonoscopy. The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate in double endoscope group were significantly lower than those in open group: (60.5 ± 25.4) min vs. (75.8 ± 20.6) min, (30.5 ± 15.8) ml vs. (55.2 ± 24.6) ml, (24.6 ± 10.5) h vs. (40.5 ± 16.8) h, (3.2 ± 1.0) d vs. (5.8 ± 2.2) d and 0 vs. 20% (4/20), and there were statistical differences (P<0.05). There was 1 case with early postoperative inflammatory bowel obstruction, 1 case with abdominal infection and 2 cases with incision infection in open group. There was no operative death in the two groups, and these patients were cured by conservative treatment. The follow-up time was 3-36 (18.6 ± 12.3) months, and all the patients survived. The patients in 2 groups had no recurrence and metastasis, no anastomotic stenosis, anastomotic leakage and other complications. Conclusions For the special types of colorectal polyps, double endoscope surgery is less invasive, with faster recovery and less complications. It is the first choice except for endoscopic resection.