[Management of large villous tumors of the lower part of the rectum].

Radical surgery (i.e. rectal resection) remains the gold standard for surgical management of large villous tumours but such a strategy is associated with potential postoperative complications with high risk of functional disorders and genito-urinary dysfunction. Transanal local surgery is an alternative treatment with low morbidity. A new procedure as transanal endoscopic microsurgery can be proposed to achieve local complete excision of rectal tumours especially in the middle and upper parts of the rectum lesions unresectable by conventional local surgery. For malignant tumours, accurate pathological evaluation to define histopathological criteria must be done to propose or not additional radical surgery.