Per-Anal Excision of Large, Rectal, Villous Adenomas

Abstract

Many series of this procedure report recurrence in up to 36 percent and significant complication in up to 19 percent of patients. Transanal endoscopic microsurgery has achieved recurrence rates of 2.8 percent and low complication rates but for economic reasons has failed to find a widespread role. This article demonstrates that large, villous tumors of the low and mid rectum can be simply and effectively treated by per-anal resection with recurrence rates equivalent to transanal endoscopic microsurgery.

Treatment of rectal adenomas by transanal endoscopic microsurgery: 15 years’ experience

“…Removal of preneoplastic lesions such as adenomas is thought to be crucial in preventing colorectal cancer. In fact, adenomas of the colon and rectum have the potential to become malignant; this potential is related to size, histological type (villous adenoma), and grade of dysplasia [4][5][6].…”

Transanal endoscopic microsurgery: a review

“…In summary, for adenomas TEM has shown excellent results, low recurrence rates and a remarkably favourable complication profile compared with TAE [54][55][56] and radical resection. 23,57 The evidence supports TEM as the preferred approach to rectal adenoma resection when colonoscopic removal is not possible.…”

Complications after transanal endoscopic microsurgical resection correlate with location of rectal neoplasms

“…Especially in multimorbid or elderly patients bleedings and perforations can become life threatening. They frequently require reoperations and extend hospital stays far beyond the average hospital stay of 3-5 days after complication-free TEMs [9][10][11]. In order to investigate tumor-specific, procedure-or surgeon-related factors influencing complications after TEM, we performed the current retrospective analysis of data entered in a prospective database.…”