Mörschel M, Heintz A, Bussmann M, Junginger T
Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz, Germany.
Langenbecks Arch Surg. 1998 Oct;383(5):320-4. doi: 10.1007/s004230050140.
Between January 1986 and December 1995, 238 patients with benign rectal polyps underwent either transanal endoscopic microsurgery (n = 226) or transanal excision (n = 12) at the Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz.
Mean polyp size was 4.2 cm; 89.1% of polyps measured more than 2 cm in diameter. In 89.1% of cases, histological analysis revealed polyps containing tubulovillous or villous adenomas. Synchronous colonic polyps were detected in 12.5% of patients. Follow-up data are available on 222 patients (94%). At follow-up examination, 169 of the 193 surviving patients (87.6%) were recurrence free. Seven of 193 patients (3.6%) had developed neoplastic colonic polyps and, in 17 patients (8.8%), metachronous polyps were detected.
Transanal endoscopic microsurgical polypectomy was furthermore demonstrated to be a low-risk procedure with a low recurrence rate for the complete resection of large rectal polyps. At a follow-up rate of 61.1 %, the incidence of metachronous carcinoma ranged at 3.1%, which is markedly below the rate of 8-18% for tubulovillous or villous adenomas larger than 1 cm in diameter cited in the literature.
1986年1月至1995年12月期间，238例直肠良性息肉患者在美因茨约翰内斯·古腾堡大学普通与腹部外科诊所接受了经肛门内镜显微手术（n = 226）或经肛门切除术（n = 12）。
息肉平均大小为4.2厘米；89.1%的息肉直径超过2厘米。在89.1%的病例中，组织学分析显示息肉含有管状绒毛状或绒毛状腺瘤。12.5%的患者检测到同步性结肠息肉。有222例患者（94%）的随访数据。在随访检查中，193例存活患者中的169例（87.6%）无复发。193例患者中有7例（3.6%）发生了结肠肿瘤性息肉，17例患者（8.8%）检测到异时性息肉。
经肛门内镜显微手术息肉切除术进一步证明是一种低风险手术，对于完整切除大型直肠息肉复发率低。随访率为61.1%时，异时性癌的发生率为3.1%，明显低于文献中报道的直径大于1厘米的管状绒毛状或绒毛状腺瘤8 - 18%的发生率。
