Researchers from Angers, France designed a study to review the outcome of endoscopic transanal resection (ETAR) for the treatment of patients with villous rectal adenomas (VRA).
The investigators included 28 consecutive patients who underwent ETAR for VRA between October 1992 and December 2000.
All tumors were believed to be benign (clinical examination, endorectal ultrasonography, multiples biopsies).
The research group performed a retrospective evaluation of the outcome of ETAR.
The researchers found that 13 patients (46.4%) had a large VRA with a tumor length of more than 5 cm and in 10 of these case, the tumour involved the anterior rectal wall.
| ETAR should be performed in collaboration with an experienced urological endoscopist|
|International Journal of Colorectal Disease|
10 patients (35.7%) were found to require more than one procedure.
The group found that the median operating time was 35 min and morbidity was 5%. No patient died.
The median postoperative stay was 3 days.
In total, the researchers confirmed on histology that 3 patients (9.3%)had adenocarcinoma of the rectum and these patients underwent a conventional surgical procedure.
The research team noted 2 recurrences at a median follow-up of 5 years.
The investigators' data suggest that the technique of transanal resection has a limited but valuable place in rectal surgery.
Dr Jean-Jacques Tuech conluded, "ETAR is a simple, minimally invasive, and economical method for treatment of patient with VRA."
He added, "ETAR should be performed in collaboration with an experienced urological endoscopist."
"ETAR is a useful addition to the surgeons armamentarium together with laser destruction and transanal endoscopic microsurgery."