[Trans-anal resection of low rectal neoplasms].
BACKGROUND
The rising incidence of colorectal neoplasms, and in particular those localised in the lower rectum is stressed and the therapeutic opportunities offered by the trans-anal resection technique are underlined.


METHODS
The indispensable conditions for adopting a surgical approach are pointed out. These are identified as the size of the neoplasm, which should not exceed 4 cm, the fixity, site, the polypoid and non-ulcerated nature of the lesion, and the involvement of not more than 1/4 of the circumference of the bowel. Using these inclusion criteria, the authors operated on five patients in the 4th Division of General Surgery at G. Martino Polyclinic in Messina, using trans-anal resection of low rectal neoplasm.


RESULTS
No hemorrhagic complications or lesions in the visceral wall occurred. All patients underwent a follow-up of up to 36 months and to date no patient has presented long-term metastasis; local recidivation was observed in one patient after 14 months and this was treated using the trans-anal method.


CONCLUSIONS
The authors affirm that trans-anal resection may be regarded as the elective treatment of patients with neoplasms confined to the visceral wall and without dissemination; it is palliative in cases where the tumour is larger than 4 cm, with lymph node involvement. But even in this case, and in more advanced situations, this method allows mortality due to occlusive complications to be reduced and ensures a better quality of residual life.
Di Mauro
S
S
Divisione di Chirurgia Generale IV, Cattedra di Chirurgia Generale, Università degli Studi, Messina, Italy.
Belnome
N A
NA
Salibra
M
M
Bartolo
V
V
La Malfa
G
G
Turrisi
M
M
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology; D013997:Time Factors