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A prospective non-randomized feasibility study enrolled 25 patients meeting clinical stage-1 criteria, with CELS failure defined by incomplete resection, early local recurrence, major complications, or perioperative mortality.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/combined-endoscopic-and-laparoscopic-surgery-cels-for-early-colon-cancer-in-high-risk-patients/384168/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/combined-endoscopic-and-laparoscopic-surgery-cels-for-early-colon-cancer-in-high-risk-patients/384168.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What patient group was CELS intended for in the study?","Question",{"text":112,"@type":113},"The study focused on selected high-risk patients with early colon cancer who had no suspicion of lymph node metastasis and who met clinical stage-1 criteria with defined fitness and risk scores.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the study define failure of CELS resection?",{"text":117,"@type":113},"Failure included incomplete resection (R1/R2), local recurrence within 3 months, CELS-related complications within 30 days with Clavien–Dindo grade ≥ 3, or death within 30 days or within 90 days due to surgical complications.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings on feasibility and pathology?",{"text":121,"@type":113},"CELS failure occurred in two patients due to incomplete resections. Pathology findings included pT1, pT2, pT3 adenocarcinomas, and non-invasive tumors; surgical strategy was changed in some patients intraoperatively and completion colectomy was performed for histological high-risk factors, while none had LNM.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},384168,1790399535,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Combined endoscopic and laparoscopic surgery (CELS) for early colon cancer in high‑risk patients  \nMorten F. S. Hartwig1,2 · Mustafa Bulut1,2,3 · Jens Ravn‑Eriksen1,2,3 · Lasse B. Hansen1,2,3 · Rasmus D. Bojesen1,2 · Mads Falk Klein4 · Henrik L. Jakobsen4 · Morten Rasmussen5 · Bo Rud6 · Jens‑Ole Eriksen7 · Susanne Eiholm7 · Anne‑Marie K. Fiehn2,3,7 · Phil Quirke8 · Ismail Gögenur2,3  \nReceived: 9 June 2023 / Accepted: 6 August 2023 / Published online: 28 September 2023 © The Author(s) 2023  \nAbstract  \nBackground Local excision of early colon cancers could be an option in selected patients with high risk of complications and no sign of lymph node metastasis (LNM). The primary aim was to assess feasibility in high-risk patients with early colon cancer treated with Combined Endoscopic and Laparoscopic Surgery (CELS) .  \nMethods A non-randomized prospective feasibility study including 25 patients with Performance Status score ≥ 1 and/or American Society of Anesthesiologists score ≥ 3, and clinical Union of International Cancer Control stage-1 colon cancer suitable for CELS resection. The primary outcome was failure of CELS resection, defined as either: Incomplete resection (R1/R2), local recurrence within 3 months, complication related to CELS within 30 days (Clavien–Dindo grade ≥ 3), death within 30 days or death within 90 days due to complications to surgery.  \nResults Fifteen patients with clinical T1 (cT1) and ten with clinical T2 (cT2) colon cancer and without suspicion of metastases were included. Failure occurred in two patients due to incomplete resections. Histopathological examination classified seven patients as having pT1, nine as pT2, six as pT3 adenocarcinomas, and three as non-invasive tumors. In three patients, the surgical strategy was changed intraoperatively to conventional colectomy due to tumor location or size. Median length of stay was 1 day. Seven patients had completion colectomy performed due to histological high-risk factors. None had LNM. Conclusions In selected patients, CELS resection was feasible, and could spare some patients large bowel resection.  \nKeywords Colon cancer · Early cancer · Combined endoscopy and laparoscopy  \n* Morten F. S. Hartwig[mofha@regionsjaelland.dk](mofha@regionsjaelland.dk)  \n1 Department of Surgery, Center for Surgical Science, Zealand University Hospital Koege, Lykkebaekvej 1, 4600 Koege, Denmark  \n2 Department of Surgery, Zealand University Hospital, Koege, Denmark  \n3 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark  \n4 Department of Surgery, Copenhagen University Hospital  \n-Herlev & Gentofte Hospital, Herlev, Denmark  \n5 Department of Surgery, Copenhagen University Hospital  \n-Bispebjerg Hospital, Copenhagen, Denmark  \n6 Department of Surgery, Copenhagen University Hospital  \n-Hvidovre Hospital, Hvidovre, Denmark  \n7 Department of Pathology, Zealand University Hospital, Roskilde, Denmark  \n8 Pathology & Data Analytics, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK  \nColorectal cancer is the third most common cancer diagnosed worldwide, and accounts for almost 10% of all cancerrelated deaths only outnumbered by lung cancer [1] . The only curable treatment is surgical resection. According to the American Society of Colon and Rectal Surgeons guidelines, treatment for localized colon cancer should include resection of the tumor and its lymphovascular drainage, covering a minimum of 5–7 cm of proximal and distal colon, to ensure complete resection of the tumor-bearing bowel segment and the mesocolic lymph nodes [2] . In contrast, polyp cancers (pT1) with free resection margins and no histopathological high-risk features can be safely treated with polypectomy and surveillance endoscopy. This recommendation is based on a relatively low risk of lymph node metastasis (LNM)[2 , 3] . For patients with early-stage colon cancer (i.e. , T1–T2), the risk of LNM is less than 20%[4, 5] . This risk and its influence on l","cbCaihhWR81GOjw1","https://ap.wps.com/l/cbCaihhWR81GOjw1","pdf",2212250,11,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Methods and Materials\n## Study design and participants\n## Inclusion criteria","[{\"question\":\"What patient group was CELS intended for in the study?\",\"answer\":\"The study focused on selected high-risk patients with early colon cancer who had no suspicion of lymph node metastasis and who met clinical stage-1 criteria with defined fitness and risk scores.\"},{\"question\":\"How did the study define failure of CELS resection?\",\"answer\":\"Failure included incomplete resection (R1/R2), local recurrence within 3 months, CELS-related complications within 30 days with Clavien–Dindo grade ≥ 3, or death within 30 days or within 90 days due to surgical complications.\"},{\"question\":\"What were the main findings on feasibility and pathology?\",\"answer\":\"CELS failure occurred in two patients due to incomplete resections. Pathology findings included pT1, pT2, pT3 adenocarcinomas, and non-invasive tumors; surgical strategy was changed in some patients intraoperatively and completion colectomy was performed for histological high-risk factors, while none had LNM.\"}]","Combined endoscopic and laparoscopic surgery (CELS) for early colon cancer in high-risk patients | PDF",1790261492,28]