Edelmann G, de Mestier P
Ann Gastroenterol Hepatol (Paris). 1984 Dec;20(6):311-4.
Villous tumours of the colon and rectum are characterized by a high incidence of malignancy (50%) and by their tendency to recur. Invasive malignant villous tumours require wide excision in the same way as adenocarcinomas. Non-invasive tumours (stage 0 and stage I) should be treated like benign villous tumours. Villous tumours of the colon, i.e. situated more than 15 cm from the anus, are removed by a short colonic resection. Villous tumours of the rectum which are small and pedunculated or sessile, situated less than 8 cm from the anus can be excised via the trans-anal route, provided a margin of healthy mucosa is removed around the villous zone. High rectal tumours which are very large or diffuse are removed by a trans-sacral approach, low extensive tumours are removed by a coccyperineal or trans-sphincteric approach. Recurrences (30 to 40%) always occur after incomplete excision, especially after a trans-anal resection. Benign tumours can also recur, although remaining benign, and require a further local excision.
结肠和直肠绒毛状肿瘤的特点是恶性发生率高（50%）且有复发倾向。侵袭性恶性绒毛状肿瘤需要像腺癌一样进行广泛切除。非侵袭性肿瘤（0期和I期）应按良性绒毛状肿瘤进行治疗。结肠绒毛状肿瘤，即位于距肛门15厘米以上的肿瘤，通过短结肠切除术切除。距肛门小于8厘米的小的有蒂或无蒂直肠绒毛状肿瘤，若在绒毛状区域周围切除一圈健康黏膜，可经肛门途径切除。非常大或弥漫性的高位直肠肿瘤通过经骶骨途径切除，低位广泛性肿瘤通过尾骨会阴或经括约肌途径切除。复发（30%至40%）总是在切除不完全后发生，尤其是经肛门切除术后。良性肿瘤也可能复发，尽管仍为良性，但需要进一步局部切除。
