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  • Title: [Transanal resection of large sessile rectal polyps].
    Author: Janssen KM, Mazee HA, Ruers TJ, Baeten CG.
    Journal: Ned Tijdschr Geneeskd; 1996 Aug 10; 140(32):1646-9. PubMed ID: 8815406.
    Abstract:
    OBJECTIVE: To assess the safety and effectiveness of transanal resection of large rectal adenomas. DESIGN: Retrospective. SETTING: Department of Surgery, University Hospital Maastricht, the Netherlands. METHOD: 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. CONCLUSION: Transanal resection of large rectal adenomas is a safe and effective method of treatment. However, the high recurrence requires frequent endoscopy.
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