MANAGEMENT OF COLONIC LIPOMAS

Background: Little is known of colonic lipomas, especially in an Asian population, and their management is controversial. Methods: A compute rized colonoscopy database was analysed and patients with colonic lipo mas were reviewed. Results: There were 16 colonic lipomas (incidence o f 0.15%) in a series of 10 658 consecutive colonoscopies. There were s even men and nine women, with a mean age of 61.8 years (range: 28-80 y ears). The size of the lipomas ranged from 1.5 to 6 cm; all those larg er than 3.5 cm were symptomatic (P = 0.05). The most common symptom wa s mild bleeding per rectum. Right-sided lipomas were palpable while le ft-sided lipomas presented with obstructive symptoms. Colonoscopic rem oval by hot biopsy or snare polypectomy was possible where the lipomas were 2.5 cm and pedunculated. Surgery was performed in six patients ( four open, two laparoscopic) for symptoms and to exclude malignancy. T here was no morbidity or mortality. Conclusions: Small or pedunculated lipomas may be safely removed colonoscopically and the diagnosis conf irmed histologically. Larger lipomas require surgical resection for re lief of symptoms or to exclude malignancy.