Intrarectal resection of villous adenoma

Summary and Conclusions The most common symptom of villous adenoma without invasive carcinoma is bleeding; many cause no symptoms. The best method of diagnosis is sigmoidoscopic examination. Usually villous adenomas are found in elderly patients (average age, 61 years) and are quite large when discovered. Usually they involve the rectum below the 15-cm. level. A method of intrarectal local removal is presented, which provides the advantage that it gives the entire specimen to the pathologist for microscopic examination; and the presence or absence of invasion can be accurately determined. By intrarectal resection, the tumor can be removed completely and leaves little likelihood of recurrence. Results in 37 cases, 23 of which had intrarectal resection, are presented. Total local excision of clinically benign villous adenoma by intrarectal resection rather than more radical procedures in the elderly poor-risk patient is advocated.