Dual Method to Remove Precancerous Colon Polyps May Substantially Reduce Health-Care Costs
A surgical method combining two techniques for removing precancerous polyps during colonoscopies can substantially reduce the recovery time and the length of hospital stays, which may translate into significant cost savings, according to research presented this week at Digestive Disease Week in Chicago.
“Not only did we find that patients were discharged a day and a half earlier, we discovered other benefits, which could transform our approach to removing difficult colon polyps,” said Jonathan Buscaglia, MD, the study’s lead researcher and the Director of Advanced Endoscopy at Stony Brook University School of Medicine.
The typical approach to these difficult-to-remove polyps is a procedure called laparoscopic hemicolectomy, in which surgeons using a laparoscope must remove an entire section of the colon that contains the polyp. In contrast to this invasive procedure, surgeons employing laparoscopic-assisted colonoscopy with polypectomy use both a laparoscope and an endoscope to isolate and remove just the polyp.
Shorter Operating and Recovery Time,
In addition to shorter discharge time (4 vs 2.5 days), researchers found that operating time for patients undergoing laparoscopic-assisted colonoscopy with polypectomy was significantly shorter than patients undergoing laparoscopic hemicolectomy (95 vs 179 minutes). Patients undergoing laparoscopic-assisted colonoscopy with polypectomy also had far less estimated blood loss (13 vs 63 mL) and required less IV fluid (2.1 vs 3.1 L).
After surgery, patients who underwent laparoscopic-assisted colonoscopy with polypectomy were able to resume eating solid foods in less than 2 days, whereas laparoscopic hemicolectomy patients had to wait nearly 4 days. Researchers found the two procedures were equivalent in terms of overall efficacy and complications.
Because this study involved 28 patients, Dr. Buscaglia and his team plan to conduct a larger, multicenter investigation to confirm these findings. The researchers also hope to compare laparoscopic-assisted colonoscopy with polypectomy vs laparoscopic hemicolectomy on removal of polyps in the left colon since this study looked exclusively at right-side colonic polyp removal.
“About 25% of patients undergoing colonoscopy require polyp removal, and a significant proportion of these patients have large polyps that cannot be easily removed by standard advanced endoscopic techniques,” said Dr. Buscaglia. “These findings suggest that we may need to tailor our surgical approach to ensure every patient receives the best care possible, regardless of polyp removal difficulty.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
