[Use of the urologic resectoscope in the treatment of rectal pathology. Analysis of our experience and review of the literature]. / Utilización del resector urológico en el tratamiento de patología rectal. Análisis de nuestra experiencia y revisión de la literatura.

ABSTRACT

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.