4 Efficacy

4 Efficacy

This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the interventional procedure overview.

4.1 In a non‑randomised comparative study of 123 patients treated by laparoscopic‑assisted endoscopic polypectomy (n=25), endoscopic mucosal resection (n=30) or laparoscopic colectomy (n=68) successful removal of polyps was reported in 76%, 77% and 100% of patients respectively. In a case series of 30 patients treated by laparoscopic‑assisted endoscopic polypectomy successful removal of polyps was reported in 73% (22/30) of patients. In these patients, all resection margins were clear. In a case series of 23 patients treated either by laparoscopic‑assisted endoscopic polypectomy or endoscopy‑assisted laparoscopic wedge resection successful removal of polyps was reported in 87% (20/23) of patients.

4.2 In a case series of 146 patients treated by various combined endoscopic and laparoscopic approaches (including laparoscopic‑assisted endoscopic polypectomy [n=8], endoscopy‑assisted wedge resection [n=72], endoscopy‑assisted transluminal resection [n=40] and endoscopy‑assisted segmental resection [n=26]) 1 recurrence of a tubulovillous adenoma was reported at mean follow‑up of 2.9 years.

4.3 In a case series of 176 patients treated by laparoscopic‑monitored endoscopic polypectomy no recurrence of resected polyps was observed at median follow‑up of 65 months.

4.4 The specialist advisers listed key efficacy outcomes as complete polyp excision allowing for complete pathological assessment, recurrence, reduced morbidity compared against standard laparoscopic resection or traditional surgery, avoidance of major laparoscopic resection and maintenance of bowel function.

  • National Institute for Health and Care Excellence (NICE)