[Indications and results of mucosal proctectomy with colo-anal anastomosis in villous disease of the rectum].
The objective of this study was to define the indication for proctectomy and colo-anal anastomosis in large rectal villous adenomas. The study population consisted of 20 patients (12 men and 8 women; mean age 63.6) who underwent rectal excision and colo-anal anastomosis from 1990 to 1997. The average size of tumors was 59.8 mm; 18 tumors were located in the lower third of the rectal ampulla; 8 patients had prior treatment (surgical or medical) before proctectomy. There were 13 straight colo-anal anastomoses and 7 constructed with colonic J pouch. Eighty percent of the anastomoses were defunctioned by a temporary stoma. The overall morbidity included one case of pelvic sepsis, two anastomotic strictures and one colonic trans-anal prolapse. One patient experienced persistent mild fecal incontinence and two others developed urogenital. The mean hospital stay was 14.4 days and 8.5 days for stoma closure. 8 tumors contained malignancy: 3 Tis, 4 T1 and 1 T2. In our opinion the extension, natural history or potential of occult malignancy of large rectal villous adenomas may requires rectal excision with colo-anal anastomosis with low morbidity and good functional results.
Petit
T
T
Service de Chirurgie Digestive, Centre Hospitalier Universitaire Caen Côte de Nacre.
Maurel
J
J
Lebreton
G
G
Gignoux
M
M
Segol
P
P
D000230:Adenocarcinoma / Q000601:surgery*; D018253:Adenoma, Villous / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D002278:Carcinoma in Situ / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies
Indications et résultats de la proctomucosectomie avec anastomose colo-anale pour maladie villeuse du rectum.