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Endoscopic treatment of carpet-like adenomas of the rectum
P Spinelli1, G Calarco, C Gallo
1Divisione di Diagnostica e Chirurgia Endoscopica, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. spinpas@tin.it
Background:
Transanal microsurgery, endoscopic laser photocoagulation and snare resection have all been used to treat large sessile adenomas of the rectum alternatively to a surgical approach. However, such modalities are often defective due to the carpet-like shape and the frequently large extension of the lesions.
Methods:
Ten patients with carpet-like adenoma were submitted to transanal endoscopic resection by urological resectoscope.
Results:
Complete eradication was obtained in all lesions. The mean number of treatment sessions was 3 (range, 1-5). The mean time between the first treatment and the complete eradication was 6 months (range, 1-18). The only complications were an intraoperative and an early postoperative bleeding. There was no early or late mortality related to the procedure.
Conclusions:
Transanal endoscopic resection by urological resectoscope appears to be a suitable therapeutic approach for sessile and carpet-like adenomas of the rectum or for pTI cancer in patients who refuse major surgery.