title: Follow-up after transanal endoscopic microsurgery or transanal excision of large benign rectal polyps.
abstract: METHODS
  Between January 1986 and December 1995, 238 patients with benign rectal polyps underwent either transanal endoscopic microsurgery (n = 226) or transanal excision (n = 12) at the Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz.
  
  
  RESULTS
  Mean polyp size was 4.2 cm; 89.1% of polyps measured more than 2 cm in diameter. In 89.1% of cases, histological analysis revealed polyps containing tubulovillous or villous adenomas. Synchronous colonic polyps were detected in 12.5% of patients. Follow-up data are available on 222 patients (94%). At follow-up examination, 169 of the 193 surviving patients (87.6%) were recurrence free. Seven of 193 patients (3.6%) had developed neoplastic colonic polyps and, in 17 patients (8.8%), metachronous polyps were detected.
  
  
  CONCLUSIONS
  Transanal endoscopic microsurgical polypectomy was furthermore demonstrated to be a low-risk procedure with a low recurrence rate for the complete resection of large rectal polyps. At a follow-up rate of 61.1 %, the incidence of metachronous carcinoma ranged at 3.1%, which is markedly below the rate of 8-18% for tubulovillous or villous adenomas larger than 1 cm in diameter cited in the literature.
authors.affiliation: Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Mörschel
authors.forename: A
authors.initials: A
authors.lastname: Heintz
authors.forename: M
authors.initials: M
authors.lastname: Bussmann
authors.forename: T
authors.initials: T
authors.lastname: Junginger
mesh_terms: D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome