Colon and Rectum

Introduction: The use of a 'rectum resector' similar to a cystoscope was reported in treatment of villous tumours of the rectum. Technique: The patient is placed in the dorsal lithotomy position: the standard urologic resectoscope is then inserted into the rectum using the obturator. After the instrument is placed under vision through the lesion. the resection is begun in much the same manner as a transuretheral resection of the prostate. The tumour is resected flat to the adjacent normal rectal wall. Resection is carried out circumferentially around the lumen until all tumour is removed. The irrigant carries the chips and blood into the colon and allows excellent visualization without anal dilatation. A few chips are gathered for pathologic examination. Patients and results: This technique has been performed in 20 patients, with a mean age of 74 years, presenting a rectal villous tumour. No mortality or morbidity were observed. The average operative time was 35 minutes and the average hospital stay was four days. There was only one recurrence treated by laser at follow-up ranging 14 to 48 months. Conclusion: This endoscopic procedure is safe. nonexpensive, easily avai I able and does not require anaesthesia: it seems to offer adequate surgery in rectal villous tumours.

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