Surgical management of large villous tumors of the rectum

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Abstract
Summary Seventy-two patients with villous tumors of the rectum were included in the study (Table 2). The tumors ranged from 2 to 12 cm in greates dimension and were 4 to 15 cm from the anal verge. Fifty-three patients had transanal excision of the lesions as a definitive treatment. The surgical technic is described. In three cases abdominoperineal resection was done for invasive carcinoma, and similar radical surgery was necessary for two extensive benign tumors which involved the entire circumference of the rectal wall. Of the 53 villous tumors removed by transanal excision, 34 were reported by the pathologist to be benign, and 19 showed superficial adenocarcinoma, with no microscopic evidence of invasion on serial sections. These tumors with carcinomain situ were considered clinically benign. The longest follow-up period was 10 1/4 years. Five patients had recurrences, two to six years after operation. None of these necessitated radical surgery. Transanal excision of clinically benign villous tumors of the rectum is considered adequate definitive treatment.