[Transanal resection of large sessile rectal polyps].
OBJECTIVE
To assess the safety and effectiveness of transanal resection of large rectal adenomas.


METHODS
Retrospective.


METHODS
Department of Surgery, University Hospital Maastricht, the Netherlands.


METHODS
35 patients underwent transanal resection of large rectal polyps. These cases were analysed as to the accuracy of preoperative biopsies, complication rate, recurrence rate and value of endoscopic follow-up.


RESULTS
Preoperative biopsies proved to be unreliable: in 49% of the cases histology of the whole specimen matched with the result of the biopsy. Five patients showed adenocarcinoma in the definite specimen, they were treated successfully by low anterior resection or rectum extirpation following the transanal resection. Six patients developed complications. In 1 patient this resulted in a colostomy. The average follow-up was 45 months. Sixty per cent of the patients in whom an adenoma or a carcinoma in situ was removed developed a recurrent adenoma. Recurrent adenomas were all treated by endoscopic polypectomy.


CONCLUSIONS
Transanal resection of large rectal adenomas is a safe and effective method of treatment. However, the high recurrence requires frequent endoscopy.
Janssen
K M
KM
Academisch Ziekenhuis, Afd. Chirurgie, Maastricht.
Mazee
H A
HA
Ruers
T J
TJ
Baeten
C G
CG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D002278:Carcinoma in Situ / Q000601:surgery; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D012812:Sigmoidoscopy