[Villous tumors of the rectum. Endoscopic treatment using photocoagulation].
We report the results of endoscopic photocoagulation in the treatment of villous adenomas of the rectum in 49 consecutive patients (26 males, and 23 females, mean age: 74 years). Twenty-six patients were treated with a high-power Nd-Yag laser (80 W/sec). After a mean of 3.4 laser sessions, all the small-sized adenomas (C1) and 88% of the intermediate-sized adenomas (C2) were healed. No extensive villous adenoma (C3) could be eradicated. Complications occurred in 5 patients. Recurrence was observed in 3 C2 patients who are still on maintenance laser therapy. Twenty-three patients were treated with another Nd-Yag laser (maximal power output: 45 W/sec). After a mean of 6.4 laser sessions, 85% of the C1 patients were healed, while eradication of villous tissues was obtained in 60% of C2 and C3 patients. No complications were noted. A recurrence was observed in three C1 patients with secondary healing after reinstitution of laser therapy in 2 cases. Moreover, two C3 patients also relapsed and laser eradication was again obtained in 1 patient. In conclusion, these results confirm the efficacy of laser therapy in small- and intermediate-sized villous adenomas of the rectum. The number of laser sessions required for eradicating a villous tumour was lower using a high-power Nd: Yag laser, but the risk of complications was increased.
Coppens
J P
JP
Desmarez
B
B
Warzee
P
P
Adler
M
M
Van Wymersch
T
T
Van Gossum
A
A
Vanheuverzwyn
R
R
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008028:Light Coagulation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*
Tumeurs villeuses du rectum. Traitement endoscopique par photocoagulation.