FOLLOW-UP AFTER TRANSANAL ENDOSCOPIC MICROSURGERY OR TRANSANAL EXCISION OF LARGE BENIGN RECTAL POLYPS

Methods: Between January 1986 and December 1995, 238 patients with ben ign rectal polyps underwent either transanal endoscopic microsurgery ( n = 226) or transanal excision (n = 12) at the Clinic of General and A bdominal Surgery, Johannes Gutenberg-University, Mainz. Results: Mean polyp size was 4.2 cm; 89.1% of polyps measured more than 2 cm in diam eter. In 89.1% of cases, histological analysis revealed polyps contain ing tubulovillous or villous adenomas, Synchronous colonic polyps were detected in 12.5% of patients. Follow-up data are available on 222 pa tients (94%). At follow-up examination, 169 of the 193 surviving patie nts (87.6%) were recurrence free, Seven of 193 patients (3.6%) had dev eloped neoplastic colonic polyps and, in 17 patients (8.8%), metachron ous polyps were detected. Conclusions: Transanal endoscopic microsurgi cal polypectomy was further more demonstrated to be a low-risk procedu re with a low recurrence rate for the complete resection of large rect al polyps. At a follow-up rate of 61.1%, the incidence of metachronous carcinoma ranged at 3.1%, which is markedly below the rate of 8-18% f or tubulovillous or villous adenomas larger than 1 cm in diameter cite d in the literature.