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Results of treatment of 78 patients (mean age 64 years) operated for benign neoplasms of a colon distal part are presented. In histologic examination tubular adenoma was found in 34 cases, tubular-villose adenoma--in 27, villose adenoma with different degree of epithelium dysplasia--in 16. In 10 patients villous tumors were located in low-ampular part of the rectum at the distance less than 7 cm from dermal-mucose line of the anal canal, in 27 patients--at 8 to 12 cm, in 42--at 12 to 20 cm. Area of neoplasm base in 53 patients ranged from 1.0 to 2.0 cm2, in 15--from 2.1 to 6 cm2, in 11-43 cm2, it was 14 cm2 on the average. For patients of the first group wire endoscopic polipectomy was adequate procedure. In 25% patients with neoplasm area more 2 cm2 recurrence of the disease was revealed from 3 months to 1 year after staged endoscopic polipectomy. Possibility of incomplete removal of creeping neoplasm at staged endoscopic electroexcision dictates the necessity of control colonoscopy 1 month after the procedure. If villous tumor recurs during 1 year in spite of repeated endoscopic procedures, it is reasonable to resect the colon because of danger of malignant transformation of the tumor. In 12 patients with villous adenomas location at 7-20 cm from the anal ring transanal endoscopic microsurgery (TEM) by G. Buess et al (1984) was performed. In follow-up for 25.8 months on the average recurrences of the disease were not revealed. TEM is thought as alternative to anterior resection of the rectum in benign tumors. |
