title: [Technic of the surgical excision of villous tumors].
abstract: Villous tumours of the colon and rectum are characterized by a high incidence of malignancy (50%) and by their tendency to recur. Invasive malignant villous tumours require wide excision in the same way as adenocarcinomas. Non-invasive tumours (stage 0 and stage I) should be treated like benign villous tumours. Villous tumours of the colon, i.e. situated more than 15 cm from the anus, are removed by a short colonic resection. Villous tumours of the rectum which are small and pedunculated or sessile, situated less than 8 cm from the anus can be excised via the trans-anal route, provided a margin of healthy mucosa is removed around the villous zone. High rectal tumours which are very large or diffuse are removed by a trans-sacral approach, low extensive tumours are removed by a coccyperineal or trans-sphincteric approach. Recurrences (30 to 40%) always occur after incomplete excision, especially after a trans-anal resection. Benign tumours can also recur, although remaining benign, and require a further local excision.
mesh_terms: D001706:Biopsy; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery*; D008722:Methods; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*
vernacular_title: Technique d'exérèse chirurgicale des tumeurs villeuses.