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Practitioners’ Corner
 e Pitfalls of Surgical Management of Colonic Polyps
Guillermo Castellvi, MD
I have submitted this article in re- gard to a recent surgical encounter with a patient.  is cautionary tale involves a laparoscopic surgical resec- tion of a pre-malignant colonic polyp during which a wrong segment of the colon was resected.
In a recent article presented at the 2016 Digestive Disease week, a study by Jenifer Nayor, MD, states that the
location of cancer/polyps determined by colonoscopy does not agree with surgical locations in almost one third of cases.  e increasing trend for colon and bowel resection is a laparoscopic approach where surgeons lose ability to palpate the lesion, in contract to open abdominal surgeries. Overall, in 31% of the cases (34/110) the endoscopic location did not match the surgi- cal location.
 e practice of tattooing the colonic lesion during colonos- copy helps guide the surgeon but this is not always obvious. If endoscopies are not accurately localizing lesions, there is poten-
tial for  awed surgical planning and the need for intraoperative changes to the planned surgical procedure.
Surgeons should be aware of the issue of inaccurate localiza- tion of the colonic tumors or polyps and discuss this with the patients. Two similar cases identi ed by surgery as right sided lesions were initially diagnosed as le  sided lesions by colonos- copy.
Returning to my patient, when the specimen removed was opened and it failed to con rm the lesion, open surgery fol- lowed and the correct segment was removed.
I hope this commentary will help to avoid a similar problem in the care of your patients who trust us to do no harm.
Be a Part of Change!
2018 FMA Annual Meeting August 3-5, 2018
Loews Sapphire Falls Resort, Orlando
Delegations from the Florida County and Specialty Medical Societies meet each summer to participate in the FMA House of Delegates where resolutions are presented, reviewed, and o entimes adopted.  ese adopted resolutions may become FMA policy, submitted to the American Medical Association, or become state legislative priorities.
If you are interested in being a part of the process, consider submitting an idea for a resolution or serving as an HCMA delegate to the FMA.  e HCMA Delegation will meet in the spring to create and review resolutions for consideration by FMA House of Delegates.
For more information, contact Elke Lubin, HCMA Executive Assistant, at 813.253.0471 or
HCMA BULLETIN, Vol 63, No. 6 – March/Aril 2018

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