Is laparoscopic resection of colorectal polyps beneficial?

Background: We set out to compare the results of laparoscopic and open resections of colorectal polyps. Methods: Forty-five consecutive patients who underwent operation by a single surgeon for endoscopically irretrievable colonic polyps between April 1992 and March 1996 were classified into the following two groups: group I, laparoscopic procedures for colonic polyps (n= 23); and group II, open procedures for colonic polyps (n= 22). Results: No significant differences were seen between the groups relative to age 71.7 ± 10.7 versus 70.6 ± 13.7 years], gender male:female = 10:13 versus 13:9], history of previous abdominal operation (eight of 23 34.8%] versus 10 of 22 45.5%]), type of pathology (villous: seven of 23 30.4%] versus four of 22 18.1%], tubulovillous: nine of 23 39.1%] versus six of 22 27.2%], tubular: three of 23 13.0%] versus seven of 22 31.8%]), size of polyps (2.6 ± 1.7 cm versus 2.7 ± 1.5 cm), or type of procedures (right hemicolectomy: 15 of 23 65.2%] versus 11 of 22 50%], sigmoid colectomy: five of 23 21.7%] versus six of 22 27.3%], left hemicolectomy: two of 23 8.7%] versus two of 22 9.1%]). There was no mortality and no difference in the incidence of postoperative complications (four of 23 17.4%] versus seven of 22 31.8%]), blood loss (167 cc versus 243 cc), number of retrieved lymph nodes (7.1 ± 5 versus 6.6 ± 4), incidence of carcinoma in polyps (two of 23 13.0%] versus four of 22 18.2%]), or medical cost ($22,840 versus $18,420), respectively, between the two groups. There were statistically significant differences in length of ileus (3.5 ± 1.0 days versus 5.5 ± 1.8 days), postoperative pain (2.3 ± 1.4 versus 3.7 ± 1.9 on postoperative day 1 patient pain rating scale 1–10]), length of hospital stay (6.5 ± 2.0 days versus 9.4 ± 2.7 days), and return to normal activity (5.2 ± 4.2 weeks versus 9.3 ± 12.1 weeks) in group I compared to group II, respectively. However, patients in group II had a longer mean specimen length (18.5 ± 6.4 cm versus 29.1 ± 22.7 cm) and a shorter mean operative time (177.6 ± 52.7 min versus 143 ± 51.4 min) than patients in group I. Conclusions: Laparoscopic colectomy for colonic polyps has definite advantages over traditional open surgery, including less postoperative pain, earlier return of bowel function, and earlier return to normal activity. Conversely, its disadvantages include longer operative time and a shorter specimen. Received: 27 January 1997/Accepted: 2 February 1998