Combined Laparoscopic-endoscopic Procedure for Colon Tumor:Report of 32 Cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the experience of combined laparoscopic-endoscopic procedure for colon tumor . Methods Clinical data of 32 cases of colon tumor receiving combined laparoscopic-endoscopic procedure from January 2011 to June 2014 were analyzed retrospectively , including 25 cases of endoscopic assisted laparoscopic operation ( laparoscopic resection of colon segment or laparoscopic radical resection of colon cancer with positioning of colonic lesions by endoscopy ) and 7 cases of laparoscopic assisted endoscopic operation ( intraoperative endoscopic resection under the monitor of laparoscopy ) . Results Twenty-five cases were performed endoscopic-assisted laparoscopic surgery , including endoscopic-assisted laparoscopic radical resection for colon cancer in 20 cases and endoscopic-assisted laparoscopic segmental resection of colon in 5 cases.The combined procedure contained endoscopic-assisted positioning lesions , laparoscopic bowel resection and reconstruction , and lymph node dissection .The success rate of endoscopic-assisted positioning was 100%(25/25).No conversion to laparotomy was required .No surgical complications occurred . Follow-up for 6 -48 months ( median, 30 months ) in 25 cases found no signs of recurrence and metastasis .One patient died of myocardial infarction and the remaining 24 patients survived .Seven cases were performed laparoscopic-assisted endoscopic surgery , including laparoscopic-assisted endoscopic submucosal dissection colon ( ESD) in 3 cases, laparoscopic-assisted endoscopic mucosal resection ( EMR) in 2 cases, and laparoscopic-assisted endoscopic polypectomy in 2 cases.Intestinal perforation occurred during the operation in 1 case of ESD, which was given a laparoscopic colon perforation repair .Follow-up for 9 -36 months ( median, 24 months) in 7 cases showed no deaths or signs of recurrence and metastasis . Conclusion Combined laparoscopic-endoscopic procedure has advantages of both laparoscopy and endoscopy to improve surgical safety , on the basis of good cooperation of laparoscopic and endoscopic teams .