Abstract:Objective:To evaluate the value and safety of the anterior transsphincteric operation for treating rectal villous adenoma.
Methods :The clinical data of 17 cases with rectal villous adenoma, including 6 cases with malignant change, operated by anterior transsphincteric approach at Changzheng hospital, from February 2000 to August 2006, were analyzed retrospectively. The distance between the anal verge and the lower margin of the tumor was 5～ 8 cm（average 7 cm）.The tumors were 2～ 5 cm in diamater.
Results:The rectal villous adenoma was completely removed with negative resection margins in all the 17 patients. Fecal continence，urinary function and sexual function were preserved successfully in all the patients. No postoperative complications developed．The postoperative pathological stage of rectal villous adenoma with malignant change was pTisN0M0 in 3 cases，pT1N0M0 in 2， and pT2N0M0 in 1．At a median follow-up of 46 months，no patients had recurrence.
Conclusions:Anterior transsphincteric approach is useful and safe for operation of rectal villous adenomas and those with early mmalignant change. It is particularly valuable for large midrectal villous adenoma.