RESUMEN
Treatment of rectal polypoid disease, particularly villous adenoma, by electrocoagulation has proven its efficacy in a large number of cases. However, it does not permit adequate control or analysis of the specimen because the morbid excrescence is destroyed. Transsphincteric or transanal surgery, anterior resection or abdominoperineal amputation are generally too aggressive for a recurrent but benign condition. The enhanced efficacy of other therapeutic modalities such as chemo-, immuno- or radiotherapy will undoubtedly be beneficial to conservative surgical management of a malignant rectal pathology. Our initial experience in 15 patients with different rectal tumors is reported. These patients were treated by endoscopic transanal resection (ETAR) utilizing the urologic resectoscope. Local control of the disease process was achieved in 66.6% of the cases with scant morbidity and a mortality rate of 7.3% (1 case). The foregoing results and those reported in the literature indicate that ETAR is a valid alternative surgical procedure for definitive treatment of sessile, villous, or mixed adenomatous polyps and certain cases of rectal adenocarcinoma. Moreover, this procedure has proved effective as palliative treatment in advanced rectal adenocarcinoma and obviates the need for stomas.
Asunto(s)
Adenocarcinoma/cirugía , Pólipos Intestinales/cirugía , Neoplasias del Recto/cirugía , Adenocarcinoma/patología , Adulto , Anciano , Femenino , Humanos , Pólipos Intestinales/patología , Masculino , Recurrencia Local de Neoplasia , Cuidados Paliativos , Neoplasias del Recto/patología , Urología/instrumentaciónRESUMEN
Puncture of cystic renal masses is useful in diagnosing a small number of cases when commonly used imaging techniques cannot determine the benign nature of the liquid mass with total accuracy. It can also be used as a therapeutic procedure in those cases with symptomatology arising from the presence of a renal cyst or functional alterations. In the present study, we report our experience using puncture-aspiration and sclerosis with 95% ethanol instillation in 12 renal cysts causing different symptoms. The procedure achieved good overall results with practically no complications. In 10 of the 12 cases the procedure was performed on an outpatient basis.