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Between 1963 and 1972, 121 new patients were treated at St. Mark's Hospital for a sessile villous or tubulovillous adenoma of the rectum. Thirty patients (25 per cent) were found to have simultaneous neoplastic lesions in the large intestine. Sphincter-preserving operations were performed whenever possible, and the various methods of treatment used are analyzed. Fourteen patients (11.6 per cent) had postoperative complications, and three patients died. Twenty-six patients are known to have had further benign tumor at the same site during the follow-up period.