Endoscopic ligation ("Loop-And-Let-Go") is effective treatment for large colonic lipomas: a prospective validation study

Iveković, Hrvoje and Rustemović, Nadan and Brkić, Tomislav and Ostojić, Rajko and Monkemuller, Klaus (2014) Endoscopic ligation ("Loop-And-Let-Go") is effective treatment for large colonic lipomas: a prospective validation study. BMC Gastroenterology, 14. p. 122. ISSN 1471-230X

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Official URL: http://doi.org/10.1186/1471-230X-14-122

Abstract

BACKGROUND: Colonic lipomas (CL) are rare benign adipose tumours usually found incidentally during colonoscopy. Endoscopic resection of symptomatic large CL remains controversial, since significant rates of perforation have been reported. In recent years, a novel technique for removal of large CL has been described, consisting of looping and ligating the lipoma with a nylon snare. The aim of our study was to evaluate the safety and efficacy of the "loop and let go" technique for large colon lipomas in a large case series. ----- METHODS: Consecutive patients referred to our institution for colonoscopy were eligible for the study. The diagnosis of CL was confirmed endoscopically by "pillow" and "naked fat" signs. Following diagnosis, lipomas were looped and ligated by endoloop. Follow-up colonoscopies were scheduled at 1- and 3-months interval. ----- RESULTS: A total of 11 patients with large CL were enrolled in study. The indications for the colonoscopy included altered bowel habits (7 patients, 64%), screening for colorectal neoplasm (3 pts, 27%) and lower gastrointestinal bleeding (1 pts, 9%). The median lesion size was 3 cm (range 2,5-6 cm). Lesions were located at the hepatic flexure in 4 patients (36%), cecum and ascending colon (4 pts, 36%), rectosigmoid (2 pts, 18%) and transverse colon (1 pts, 9%). There were no immediate and late complications. On follow-up (median follow-up time 11.9 months, range 8-24), there was one small residual lipoma (<1 cm). ----- CONCLUSION: The results of this study confirm that "loop-and-let-go" technique is safe and efficacious treatment of large colonic lipomas.

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© Ivekovic et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0) applies to the data made available in this article, unless otherwise stated.

MeSH:

Aged ; Cohort Studies ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery ; Colonoscopy/methods ; Female ; Humans ; Ligation/methods ; Lipoma/pathology ; Lipoma/surgery ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

Departments:

Katedra za internu medicinu

Depositing User:

Marijan Šember

Status:

Published

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