VILLOUS ADENOMA OF THE LARGE BOWEL

For past 11 years, we experienced 7 cases of villous adenoma of the large bowel. These masses topically located at the rectum in 4 cases, at the sigmoid colon in 2, and at the ascending colon in one. Various preoperative tests revealed that the masses with sizes of 1.0-12.0cm in diameter were all benign. Thus the masses smaller than 2cm were subjected to endoscopical polypectomy, and the masses larger than 2cm, local or intestinal resection. Resected specimens were histologically determined during surgery and serial sections of the whole lesion were made to detect cancer cells and their staging if the malignancies were developed. All cases were clarified to be villous adenoma with no cancerous cells. Accordingly, no additional operation corresponding to that for colorectal cancer was done. A high possibility of canceration in this disease offers a problem what type of operation is selected, and we employ the above-mentioned surgical treatment in principle. The radical operation, however, might be better to select first; when digital examination of the rectum could detect a palpable hard mass lacking in movability; when barium enema and rectoscopical examinations revealed a dimpling lesion on the surface of mass; or when a mass located to oral side of the sigmoid colon.