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Posterior Resection of Selected Rectal Tumors

Posterior Resection of Selected Rectal Tumors Abstract Villous adenoma is an unusual tumor of the colon, occurring largely in the rectum, that can usually be cured by adequate local excision. Over a five-year period, seven patients with villous adenoma of the retroperitoneal rectum and one poor-risk patient with adenocarcinoma were treated by posterior local excision of the tumor. All of them had large tumors with a wide base of attachment. Their average age was 67 years and they have been observed for an average of 36 months. There were no deaths and no substantial complications except a fecal fistula in one patient that required a temporary colostomy. One patient had a local recurrence of the benign villous adenoma after 47 months. The technique of posterior resection is simple and well tolerated. Posterior resection should not be used for adenocarcinoma of the rectum of a more radical procedure is possible. References 1. Kraske P: Zur Exstirpation hochsitzender Mastdarmkrebse . Verh Dtsch Gs Chir 14:464-474, 1885. 2. Best RR, Rasmussen JA: Results of sphincter-saving operation for carcinoma of midrectum . JAMA 164:739-742, 1957.Crossref 3. Donaldson GA, Rodkey GU, Behringer GE: Resection of the rectum with anal preservation . Surg Gynecol Obstet 123:571-580, 1966. 4. Localio SA: Abdominal-transsacral resection and anastomosis for midrectal carcinoma . Surg Gynecol Obstet 132:123-127, 1971. 5. Corman ML: Sphincter-saving operations . Surg Clin North Am 53:405-415, 1973. 6. Wheat MW Jr, Ackerman LV: Villous adenomas of the large intestine: Clinicopathologic evaluation of 50 cases of villous adenomas with emphasis on treatment . Ann Surg 147:476-487, 1958.Crossref 7. Sunderland DA, Binkley GE: Papillary adenomas of the large intestine . Cancer 1:184-207, 1948.Crossref 8. Turell R, Haller JD: A re-evaluation of the malignant potential of colorectal adenomas . Surg Gynecol Obstet 119:867-887, 1964. 9. Nicoloff DM, Ellis CM, Humphrey EW: Management of villous adenomas of the colon and rectum . Arch Surg 97:254-260, 1968.Crossref 10. Schapiro S: Villous papilloma of the rectum and colon . Arch Surg 91:362-370, 1965.Crossref 11. Bacon HE, Eisenberg SW: Papillary adenoma or villous tumor of the rectum and colon . Ann Surg 174:1002-1008, 1971.Crossref 12. McCabe JC, McSherry CK, Sussman EB, et al: Villous tumors of the large bowel . Am J Surg 126:336-342, 1973.Crossref 13. Hanley PH, Hines MO, Ray JE: Villous tumors: Experience with 217 patients . Am Surg 37:190-197, 1971. 14. Orringer MB, Eggleston JC: Papillary (villous) adenomas of the colon and rectum . Surgery 72:378-387, 1972. 15. Evans JT, Imahori S, Liu K: Villous adenoma of the colon and rectum in older patients . Geriatrics 27:80-84, 1972. 16. Ramirez RF, Culp CE, Jackman RJ, et al: Villous tumors of the lower part of the large bowel . JAMA 194:863-867, 1965.Crossref 17. Liechty RD, Raterman L: Villous adenomas: A surgical dilemma . Arch Surg 87:107-111, 1963.Crossref 18. Dreese WC, Grodinger BC, Hellwig CA, et al: Villous tumors of the rectum and sigmoid . Surg Gynecol Obstet 115:182-186, 1962. 19. Bevan AD: Carcinoma of the rectum: Treatment by local excision . Surg Clin North Am 1:1233-1241, 1917. 20. David VC: Papillomata of the large bowel . Am Surg 82:109-119, 1925. 21. David VC: The management of polyps occurring in the rectum and colon . Surgery 14:387-394, 1943. 22. Oh C, Kark AE: The transsphincteric approach to mid and low rectal villous adenoma . Ann Surg 176:605-612, 1972.Crossref 23. Crowley RT, Davis DA: A procedure for total biopsy of doubtful polypoid growths of the lowest large bowel segment . Surg Gynecol Obstet 93:23-26, 1951. 24. Lockwood RA, Taylor WA: Posterior surgical approach to the rectum . Calif Med 85:104-106, 1956. 25. Miller JM: Removal of large sessile polyps of the rectum . Am J Gastroenterol 26:596-601, 1956. 26. Wilson SE, Gordon HE: Excision of rectal lesions by the Kraske approach . Am J Surg 118:213-217, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Posterior Resection of Selected Rectal Tumors

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360110193033
Publisher site
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Abstract

Abstract Villous adenoma is an unusual tumor of the colon, occurring largely in the rectum, that can usually be cured by adequate local excision. Over a five-year period, seven patients with villous adenoma of the retroperitoneal rectum and one poor-risk patient with adenocarcinoma were treated by posterior local excision of the tumor. All of them had large tumors with a wide base of attachment. Their average age was 67 years and they have been observed for an average of 36 months. There were no deaths and no substantial complications except a fecal fistula in one patient that required a temporary colostomy. One patient had a local recurrence of the benign villous adenoma after 47 months. The technique of posterior resection is simple and well tolerated. Posterior resection should not be used for adenocarcinoma of the rectum of a more radical procedure is possible. References 1. Kraske P: Zur Exstirpation hochsitzender Mastdarmkrebse . Verh Dtsch Gs Chir 14:464-474, 1885. 2. Best RR, Rasmussen JA: Results of sphincter-saving operation for carcinoma of midrectum . JAMA 164:739-742, 1957.Crossref 3. Donaldson GA, Rodkey GU, Behringer GE: Resection of the rectum with anal preservation . Surg Gynecol Obstet 123:571-580, 1966. 4. Localio SA: Abdominal-transsacral resection and anastomosis for midrectal carcinoma . Surg Gynecol Obstet 132:123-127, 1971. 5. Corman ML: Sphincter-saving operations . Surg Clin North Am 53:405-415, 1973. 6. Wheat MW Jr, Ackerman LV: Villous adenomas of the large intestine: Clinicopathologic evaluation of 50 cases of villous adenomas with emphasis on treatment . Ann Surg 147:476-487, 1958.Crossref 7. Sunderland DA, Binkley GE: Papillary adenomas of the large intestine . Cancer 1:184-207, 1948.Crossref 8. Turell R, Haller JD: A re-evaluation of the malignant potential of colorectal adenomas . Surg Gynecol Obstet 119:867-887, 1964. 9. Nicoloff DM, Ellis CM, Humphrey EW: Management of villous adenomas of the colon and rectum . Arch Surg 97:254-260, 1968.Crossref 10. Schapiro S: Villous papilloma of the rectum and colon . Arch Surg 91:362-370, 1965.Crossref 11. Bacon HE, Eisenberg SW: Papillary adenoma or villous tumor of the rectum and colon . Ann Surg 174:1002-1008, 1971.Crossref 12. McCabe JC, McSherry CK, Sussman EB, et al: Villous tumors of the large bowel . Am J Surg 126:336-342, 1973.Crossref 13. Hanley PH, Hines MO, Ray JE: Villous tumors: Experience with 217 patients . Am Surg 37:190-197, 1971. 14. Orringer MB, Eggleston JC: Papillary (villous) adenomas of the colon and rectum . Surgery 72:378-387, 1972. 15. Evans JT, Imahori S, Liu K: Villous adenoma of the colon and rectum in older patients . Geriatrics 27:80-84, 1972. 16. Ramirez RF, Culp CE, Jackman RJ, et al: Villous tumors of the lower part of the large bowel . JAMA 194:863-867, 1965.Crossref 17. Liechty RD, Raterman L: Villous adenomas: A surgical dilemma . Arch Surg 87:107-111, 1963.Crossref 18. Dreese WC, Grodinger BC, Hellwig CA, et al: Villous tumors of the rectum and sigmoid . Surg Gynecol Obstet 115:182-186, 1962. 19. Bevan AD: Carcinoma of the rectum: Treatment by local excision . Surg Clin North Am 1:1233-1241, 1917. 20. David VC: Papillomata of the large bowel . Am Surg 82:109-119, 1925. 21. David VC: The management of polyps occurring in the rectum and colon . Surgery 14:387-394, 1943. 22. Oh C, Kark AE: The transsphincteric approach to mid and low rectal villous adenoma . Ann Surg 176:605-612, 1972.Crossref 23. Crowley RT, Davis DA: A procedure for total biopsy of doubtful polypoid growths of the lowest large bowel segment . Surg Gynecol Obstet 93:23-26, 1951. 24. Lockwood RA, Taylor WA: Posterior surgical approach to the rectum . Calif Med 85:104-106, 1956. 25. Miller JM: Removal of large sessile polyps of the rectum . Am J Gastroenterol 26:596-601, 1956. 26. Wilson SE, Gordon HE: Excision of rectal lesions by the Kraske approach . Am J Surg 118:213-217, 1969.Crossref

Journal

Archives of Surgery – American Medical Association

Published: May 1, 1975

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