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KMID : 0356719990150040301
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Journal of the Korean Society of Coloproctology
1999 Volume.15 No. 4 p.301 ~ p.306
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Surgical Review of the Rectal Villous Adenoma
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Lee Jong-Ho
Kim Hung-Dai
Son Byung-Ho
Yoo Chang-Hak
Park Yong-Lai
Shin Jun-Ho
Kim Yong-Shin
Han Won-Kon
Bae Won-Gil
Kim Kwang-Yeon
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Abstract
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Purpose: This study was undertaken to evaluate retrospectively the clinical results of surgery for the rectal villous adenoma.
Methods: The study took place from the period of Mar. of 1988 to Feb. 1998 at the Dept. of Surgery, Sungkyunkwan Univ., Medical college. The study consisted of : Among the 97 cases diagnosed with colon & rectal villous adenoma, and 59 were rectal villous adenoma, and 42 cases underwent resection. We focused on these 42 cases, especially on the position of tumor, its size, surgical technique, histologic results & keeping close follow up post- surgically.
Results: The sex ratio was 2：1 with male predominence, 18 cases were in their fifties with the average age of 55. In 30 cases, the lesion was situated within the 8 cm of anal verge. The average size of tumor was 3.64 cm. The applied methods were; rectotomy 19 cases, anterior resection 13 cases (including low anterior resection), endoscopic excision and transanal excision were 7 cases, and 2 cases, respectively. And in one case where the tumor size was 14.5 cm and which was situated within 3 cm of anal verge, Miles’ operation was conducted. Death due to post-operative complication was not observed. 2 cases of wound infection in postoperation, one case of transient urinary incontinence & hematoma were found. And in the case of explo-laparotomy, anastomosis site leakage, in one case, anastomosis site stricture in 2 cases were noted. malignant cells were observed in total of 73.8%, among these, 80% were from villous adenoma, 70% from tubullovillous adenoma. In the case of tumor size less 1 cm, and tumor size greater than 1 cm, the probability of finding malignant lesion were 33.3% and 76.9%, respectively.
Conclusion: We suggest that wide excision through York-Mason approach is a safe and effective technique for huge villous adenomas of the rectum.
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KEYWORD
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Villous adenoma, Posteroir rectotomy, York Mason approach
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