ENDOSCOPIC TRANSANAL RESECTION IN THE MANAGEMENT OF PATIENTS WITH SESSILE RECTAL ADENOMAS, ANASTOMOTIC STRICTURE AND RECTAL-CANCER

Forty patients underwent 61 endoscopic transanal resections using a ur ological resectoscope. Preoperative diagnoses were adenoma in 28 patie nts, carcinoma in seven and benign anastomotic stricture in five. Four patients with adenomas were found to have frank carcinoma. Ablation o f 22 of 23 adenomas was achieved, 11 with a single transanal resection . Open operation was required for one patient. Locally advanced rectal malignancy was palliated in five of seven patients. All those with be nign anastomotic stricture were cured by a single resection. The media n operating time was 25 min, with 11 procedures exceeding 30 min. Ther e were complications in seven cases (six bleeding, one septicaemia). T he median hospital stay for the procedure alone was 3.5 days. There we re no deaths within 30 days of operation. Endoscopic transanal resecti on is minimally invasive, quick, safe and effective. Histological surv eillance is a major advantage and appears reliable. Low complication r ates can be achieved by opting for several 'easy' resections and by re stricting use of the procedure to lesions within 15 cm of the anal ver ge.