Efficacy of gasless transanal endosurgery for large rectal villous adenomas: F26


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Abstract

Aim:The efficacy of gasless transanal endosurgery and colonoscopic excision for large rectal villous adenoma was compared.Method:Three hundred and seventy-eight patients with a large rectal villous adenoma (> 3 cm) underwent a minimal invasiveprocedure between 1999 and 2009. One hundred and forty-six (38.6%) (group 1) underwent gasless transanal endosurgery, 59 (15.6%) underwent conventional transanal excision (group 2) and 173 (45.8%) underwent colonoscopic excision (group 3).Results:Postoperative morbidity was lower in group 1 [4 (2.7%)] compared with group 2 [7 (11.9%) P < 0.0001]. No difference in morbidity was detected when compared with group 3 [5 (2.8%) P = 0.8]. Recurrence occurred in 11 (7.6%) in group 1, in 12 (20.3%) in group 2 and in 31 (17.9%) in group 3. Recurrence was lower in group 1 than in group 2 (P = 0.01) and in group 3 (P < 0.0001).Conclusion:Gasless transanal endosurgery is effective for large rectal villous adenomas in comparison with conventional transanal surgery and colonoscopic removal.

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