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Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis()
INTRODUCTION: Colorectal cancer is an important cause of death. Most cases of colon and rectal cancer arise from a preexisting adenomatous polyp. However, if colorectal polyps are very large or not accessible for endoscopic ablation, or if they cannot be removed without an increased risk of perforat...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921655/ https://www.ncbi.nlm.nih.gov/pubmed/24441716 http://dx.doi.org/10.1016/j.ijscr.2013.12.003 |
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author | Roriz-Silva, Renato Andrade, Alexei Almeida Ivankovics, Ivan Gregório |
author_facet | Roriz-Silva, Renato Andrade, Alexei Almeida Ivankovics, Ivan Gregório |
author_sort | Roriz-Silva, Renato |
collection | PubMed |
description | INTRODUCTION: Colorectal cancer is an important cause of death. Most cases of colon and rectal cancer arise from a preexisting adenomatous polyp. However, if colorectal polyps are very large or not accessible for endoscopic ablation, or if they cannot be removed without an increased risk of perforation, surgical procedures are required. PRESENTATION OF CASE: The case of a patient with a giant villous adenoma of the rectum is described. The patient had diarrhea for 2 years associated with asthenia. Colonoscopy revealed a sessile lesion in the rectum measuring 14 cm in the largest diameter. Rectal eversion technique was used, resecting the lesion under direct visibility and an external coloanal anastomosis was performed. Surgery was satisfactory and the resection margins were free. DISCUSSION: Removal of these polyps should be performed aiming to reduce the incidence of colorectal cancer, as well as to control local and systemic symptoms, such as diarrhea and fluid and electrolyte disorders, mainly in villous adenomas. Various surgical techniques are proposed, but in extensive circumferential lesions of the rectum they are difficult to apply. The rectal stump eversion technique was described by Maunsell (1892), for rectal cancer. CONCLUSION: Eversion of the rectal stump and external coloanal anastomosis may be a good surgical alternative for resecting giant rectal adenomas. |
format | Online Article Text |
id | pubmed-3921655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-39216552014-02-12 Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() Roriz-Silva, Renato Andrade, Alexei Almeida Ivankovics, Ivan Gregório Int J Surg Case Rep Article INTRODUCTION: Colorectal cancer is an important cause of death. Most cases of colon and rectal cancer arise from a preexisting adenomatous polyp. However, if colorectal polyps are very large or not accessible for endoscopic ablation, or if they cannot be removed without an increased risk of perforation, surgical procedures are required. PRESENTATION OF CASE: The case of a patient with a giant villous adenoma of the rectum is described. The patient had diarrhea for 2 years associated with asthenia. Colonoscopy revealed a sessile lesion in the rectum measuring 14 cm in the largest diameter. Rectal eversion technique was used, resecting the lesion under direct visibility and an external coloanal anastomosis was performed. Surgery was satisfactory and the resection margins were free. DISCUSSION: Removal of these polyps should be performed aiming to reduce the incidence of colorectal cancer, as well as to control local and systemic symptoms, such as diarrhea and fluid and electrolyte disorders, mainly in villous adenomas. Various surgical techniques are proposed, but in extensive circumferential lesions of the rectum they are difficult to apply. The rectal stump eversion technique was described by Maunsell (1892), for rectal cancer. CONCLUSION: Eversion of the rectal stump and external coloanal anastomosis may be a good surgical alternative for resecting giant rectal adenomas. Elsevier 2013-12-17 /pmc/articles/PMC3921655/ /pubmed/24441716 http://dx.doi.org/10.1016/j.ijscr.2013.12.003 Text en © 2013 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Article Roriz-Silva, Renato Andrade, Alexei Almeida Ivankovics, Ivan Gregório Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title | Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title_full | Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title_fullStr | Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title_full_unstemmed | Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title_short | Giant rectal villous adenoma: Surgical approach with rectal eversion and perianal coloanal anastomosis() |
title_sort | giant rectal villous adenoma: surgical approach with rectal eversion and perianal coloanal anastomosis() |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921655/ https://www.ncbi.nlm.nih.gov/pubmed/24441716 http://dx.doi.org/10.1016/j.ijscr.2013.12.003 |
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