{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:31:16Z","timestamp":1792290676479,"version":"4.4.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001734","name":"Copenhagen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Combined endoscopic laparoscopic surgery (CELS) is a minimally invasive alternative treatment for complex colonic polyps that can reduce surgical overtreatment. We report implementing a standardized treatment strategy with patients selected for CELS procedures via multidisciplinary team (MDT) conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational cohort study included 97 consecutive patients treated with CELS between 2016 and 2022. All cases were discussed by either a benign or malignant MDT. Two CELS techniques were employed: endoscopically assisted wedge resection (EA-WR) and laparoscopically assisted endoscopic mucosal resection (LA-EMR). Patients with suspected malignancies underwent step-up segmental resection (SR) if necessary. Primary outcomes were morbidity and mortality; secondary outcomes included adherence to MDT decisions, procedure durations, length of stay (LOS), histopathology, recurrence, and follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The approach decided by the MDT was unchanged in 81% of cases (79\/97). Median age was 70\u00a0years and 43% were female. Lesions had a mean size of 31\u00a0mm and were predominantly located in the right colon. Technical success for lesion removal during the index procedure was 98% (95\/97), with 93% completed by CELS alone. Median operative durations were shorter for EA-WR (52\u00a0min) and LA-EMR (73\u00a0min) than for SR (163\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median LOS was 1\u00a0day for CELS and 5\u00a0days for SR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Eleven patients (11.3%) experienced complications; four required re-interventions. Adenocarcinomas were found in 15 patients (15\/97, 12.6%), with treatment individualized based on intraoperative and histological findings. The recurrence rate for benign lesions was 4%; these recurrences were exclusively in the LA-EMR group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An MDT-guided strategy incorporating CELS, with optional intraoperative step-up, is an individualized and organ-preserving approach to managing complex colonic lesions that minimizes unnecessary surgical resections. This strategy has the potential to improve clinical decision-making and should be validated in multicenter settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-026-05131-9","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:56:26Z","timestamp":1777413386000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multidisciplinary team-guided combined endoscopic laparoscopic surgery for complex colonic lesions: a single-center retrospective cohort study"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-8180","authenticated-orcid":false,"given":"Mustafa","family":"Bulut","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svend","family":"Knuhtsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Ravn","family":"Eriksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse","family":"Bremholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"G\u00f6genur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"3","key":"5131_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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