Surgical treatment of colorectal tubulovillous adenomas in Pauls Stradins Clinical University Hospital Department of Surgery from 2018–2020

Evaluate current situation in surgical management of colorectal tubulovillous adenomas and presence of malignization in operation material, recurrence of the disease in postoperative period. A retrospective study of 71 cases in Pauls Stradins Clinical University Hospital (PSKUS Department of Surgery in a period of 3 years (2018– 2020). Total number of the patients – 71. Patients with known medical conditions like FAP syndrome, Crohn’s disease, ulcerative colitis were excluded. Female 55% (N=39), male 45% (N=32). Median age 69.0 years (66.4-70.8). Patients with several polyps (≥2 polyps) present at once – 12. Number of total polyps evaluated – 85. Localization of polyps: caecum – 8, ascending colon – 15, transverse colon – 3, descending colon – 2, sigmoid colon – 13, rectosigmoidal part – 3, rectum – 40. Types of operations: right side hemicolectomy – 18, resection of transverse colon – 3, left side hemicolectomy – 2, sigmoid resection – 9, rectosigmoidal resection – 4, rectum resection – 7, transanal excision – 30 (transanal vs transabdominal operations – 42% vs 58%; laparoscopic vs conventional transabdominal operations – 32% vs 68%). Tubulovillous adenoma in preoperative biopsies – in all cases. Malignization found in 31% of cases (22 out of 71). Correlation between malignization and the size of the polyp ≥2cm (r=0.396, p<0.001) and volume of the polyp (r=0.355, p=0.002) was detected. No correlation between the volume and localization of the polyp (p=0.411), and malignization and localization of the polyp (p=0.177) was found. Recurrence was detected in one case after 2-year follow up. Correlation between malignization of tubulovillous adenoma and the size and volume of the polyp was established. No correlation was found between localization and volume, as well as localization and malignization of the tubulovillous polyp. Risk of recurrence in case of radical surgery is low.