Tags

Type your tag names separated by a space and hit enter

Safe techniques for endoscopic resection of gastrointestinal lipomas.
Surg Laparosc Endosc Percutan Tech. 2011 Aug; 21(4):218-22.SL

Abstract

PURPOSE

Gastrointestinal (GI) lipomas are rare, benign, slowly growing, submucosal tumors, which can either be incidentally found as silent tumors of the GI tract or be the cause for GI bleeding, anemia, intussusception, and bowel obstruction. Endoscopic removal is a valid alternative to surgical resection of these tumors. In the recent past, many submucosal lipomas were for the most part resected surgically due to the risk of perforation using endoscopy. There are newer techniques available to allow safe endoscopic removal of these lesions. We present 3 successful techniques tailored to the location of the lipoma and size.

METHODS

In our unit, 3 symptomatic GI lipomas were referred to us for surgical resection, 2 originating from the duodenum and 1 from the cecum were diagnosed and resected under endoscopic ultrasound and endoscopy. We performed 3 different techniques to remove these lipomas. One of the lipomas in the duodenum was in the duodenal bulb. It was mobile and 3 cm in size. We attempted to remove this broad-based lipoma by snare and cut technique after its borders were elevated with injection of saline and epinephrine. The second duodenal lipoma was 1.5 cm. This pedunculated lipoma was located in the second portion, on the pancreatic side of the duodenum proximal to ampulla. This lipoma was lifted up with a snare and its base was cauterized resulting in successful removal. The third GI lipoma was 3.5 cm in size pedunculated and located in the cecum. The base of this pedunculated lipoma was ligated with poly loop device and endoclip resulting in ischemia and spontaneous separation of the lipoma from the colonic wall. All cases were revisited with follow-up endoscopy. All 3 methods, when used selectively, were found to be very safe and effective.

RESULTS

All 3 lesions were successfully removed and histopathologically confirmed to be lipomas. After endoscopic removal, no complications were observed.

CONCLUSIONS

Carefully selected GI lipomas, which in the past have required surgical resection due to high risk for perforation can be endoscopically removed with great success.

Authors+Show Affiliations

Department of Minimally invasive Surgery and Advanced Endoscopy, St. Vincent Hospital, Indianapolis, IN, USA. nail_aydin@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21857468

Citation

Aydin, Huseyin Nail, et al. "Safe Techniques for Endoscopic Resection of Gastrointestinal Lipomas." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, vol. 21, no. 4, 2011, pp. 218-22.
Aydin HN, Bertin P, Singh K, et al. Safe techniques for endoscopic resection of gastrointestinal lipomas. Surg Laparosc Endosc Percutan Tech. 2011;21(4):218-22.
Aydin, H. N., Bertin, P., Singh, K., & Arregui, M. (2011). Safe techniques for endoscopic resection of gastrointestinal lipomas. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 21(4), 218-22. https://doi.org/10.1097/SLE.0b013e31821ea189
Aydin HN, et al. Safe Techniques for Endoscopic Resection of Gastrointestinal Lipomas. Surg Laparosc Endosc Percutan Tech. 2011;21(4):218-22. PubMed PMID: 21857468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safe techniques for endoscopic resection of gastrointestinal lipomas. AU - Aydin,Huseyin Nail, AU - Bertin,Peter, AU - Singh,Kirpal, AU - Arregui,Maurice, PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2012/1/11/medline SP - 218 EP - 22 JF - Surgical laparoscopy, endoscopy & percutaneous techniques JO - Surg Laparosc Endosc Percutan Tech VL - 21 IS - 4 N2 - PURPOSE: Gastrointestinal (GI) lipomas are rare, benign, slowly growing, submucosal tumors, which can either be incidentally found as silent tumors of the GI tract or be the cause for GI bleeding, anemia, intussusception, and bowel obstruction. Endoscopic removal is a valid alternative to surgical resection of these tumors. In the recent past, many submucosal lipomas were for the most part resected surgically due to the risk of perforation using endoscopy. There are newer techniques available to allow safe endoscopic removal of these lesions. We present 3 successful techniques tailored to the location of the lipoma and size. METHODS: In our unit, 3 symptomatic GI lipomas were referred to us for surgical resection, 2 originating from the duodenum and 1 from the cecum were diagnosed and resected under endoscopic ultrasound and endoscopy. We performed 3 different techniques to remove these lipomas. One of the lipomas in the duodenum was in the duodenal bulb. It was mobile and 3 cm in size. We attempted to remove this broad-based lipoma by snare and cut technique after its borders were elevated with injection of saline and epinephrine. The second duodenal lipoma was 1.5 cm. This pedunculated lipoma was located in the second portion, on the pancreatic side of the duodenum proximal to ampulla. This lipoma was lifted up with a snare and its base was cauterized resulting in successful removal. The third GI lipoma was 3.5 cm in size pedunculated and located in the cecum. The base of this pedunculated lipoma was ligated with poly loop device and endoclip resulting in ischemia and spontaneous separation of the lipoma from the colonic wall. All cases were revisited with follow-up endoscopy. All 3 methods, when used selectively, were found to be very safe and effective. RESULTS: All 3 lesions were successfully removed and histopathologically confirmed to be lipomas. After endoscopic removal, no complications were observed. CONCLUSIONS: Carefully selected GI lipomas, which in the past have required surgical resection due to high risk for perforation can be endoscopically removed with great success. SN - 1534-4908 UR - https://www.unboundmedicine.com/medline/citation/21857468/Safe_techniques_for_endoscopic_resection_of_gastrointestinal_lipomas_ L2 - http://dx.doi.org/10.1097/SLE.0b013e31821ea189 DB - PRIME DP - Unbound Medicine ER -