P86 COMBINED ENDOSCOPIC AND SURGICAL PROCEDURE FOR EXCISION OF A GIANT FIBROVASCULAR POLYP

Abstract

Abstract Aim Giant fibrovascular polyp of the oesophagus is a rare benign condition.(1) We share our experience of removing a particularly large lesion and describe a combined endoscopic and surgical procedure used to remove it through only a cervical incision. Background & Methods A 53 year old year old female was referred to our department following endoscopy which demonstrated a giant fibrovascular polyp. A literature search was performed using EMBASE and Pubmed databases to identify any relevant case reports and articles. Written consent for presentation of the case and use of images was obtained from the patient. Results Surgery was carefully planned with thorough pre-operative assessment. Upper GI endoscopy was initially performed and a radio-opaque feeding tube was positioned around the base of the polyp and withdrawn proximally to delineate the proximal origin of the lesion in theatre with an image intensifier. A cervical oesophagotomy was performed under endoscopic guidance. The base of the polyp was divided with sharp dissection and transfixed. The polyp was then successfully delivered via the cervical oesophagotomy without causing any further trauma. The patient made a good recovery without any complications at follow-up. Conclusion Intraoperative endoscopy with a radio-opaque sling in these patients can direct the site of the cervical oesophagotomy, which can be guided to avoid the stalk of the lesion by an endoscope within the oesophagus.