[Protruding isolated rectal and anal neoplastic polyps removed by local transanal excision: our experience with 16...

Local transanal excision as primary treatment of rectal and anal canal adenomas in selected patients is supported by the recent literature. Sixteen patients with low rectal or anal canal neoplastic polyps underwent transanal resection. Postoperatively, 5 patients (31.25%) had complications, consisting in 2 cases of bleeding (12.5%) and 3 of urine retention (18.75%). Histologically, 2 were tubular adenomas without atypia (12.5%), 3 were tubulo-villous adenomas with moderate atypia (18.75%), 8 were tubulo-villous adenomas (50%) with severe atypia, 2 were tubulo-villous adenomas with locally invasive foci of adenocarcinoma (12.5%), and 1 case was a pT1 cloacogenic carcinoma (6.25%). The mean follow-up was 21.7 months (range: 12-36 months). One patient had a double recurrence at 8 months and after a further 6 months. After the third surgical operation the patient had no further recurrence. The outcomes were similar to those reported in the recent literature, showing that the procedure, when correctly performed, is simple and effective, with a good risk/benefit ratio.