FACTORS PREDICTING RECURRENCE AFTER SURGERY FOR VILLOUS TUMORS OF THE RECTUM - MANAGEMENT OF 184 CASES

The aim of this retrospective study on 184 operated cases was to propose a therapeutic management scheme for villous tumours of the rectum. Among the 184 operated patients, 167 (90, 7%), mean age 65 years, were seen after a follow-up of 2 to 20 years. The tumour was most often localized in the rectal ampoula (141 cases) and was benign in 65 p. 100. Endoanal surgery was performed in 76 patients among whom recurrence was observed in 29.7%. Posterior exeresis (Kraske method) was performed in 52 cases with a recurrence rate of 31.9%). Finally, abdominoperineal amputation was performed 20 times, essentialy for advanced stage tumours. Based on the statistical analysis of the recurrence factors for these different techniques, we have concluded that endoanal surgery predominates for benign tumours smaller than 5 cm situated at least 8 cm from the anus. Above the size of 5 cm, due to the major risk of tumourectomy, we believe rectal exersis is the most rational treatment.