{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:39:14Z","timestamp":1747183154253,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rectal malignant polyps can be managed by use of trans\u2010anal resections (TAR). Traditional techniques of resection have been replaced by use of platforms such as trans\u2010anal minimally invasive surgery (TAMIS) or trans\u2010anal endoscopic microsurgery (TEM). This study reviewed the management of rectal malignant polyps, in particular focussing on when clinicians used TAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A population wide cohort study of all malignant rectal polyps diagnosed in Queensland, Australia from 2011 to 2018 was undertaken. Patient and pathological factors were compared across the management strategies of polypectomy, TAR and rectal resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 430 patients were diagnosed with a malignant rectal polyp during the study period, with 103 undergoing a TAR. There was increasing use of TAR across the study period as a management strategy (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001). Polypectomy alone was more likely to be the management strategy over TAR or rectal resection if there were clear margins (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001). The distance to the closest polypectomy margin was also significantly higher in the polypectomy group with mean clearance 2.09\u2009mm in polypectomy group versus 0.86\u2009mm in TAR group and 0.99\u2009mm in resection group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001). Rectal resection was more likely to be the management strategy over TAR if there was LVI (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), depth of invasion was deeper (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) and there was tumour budding (<jats:italic>P<\/jats:italic>\u00a0=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TAR is an effective management strategy for rectal polyps and is utilized particularly in rectal malignant polyps when there are close or involved margins. Future guideline development should consider incorporation of TAR given the advances in techniques afforded by TAMIS or TEM platforms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17917","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T11:10:13Z","timestamp":1658142613000},"page":"2949-2955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A population\u2010based study of the management of rectal malignant polyps and the use of trans\u2010anal surgery"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4083-220X","authenticated-orcid":false,"given":"Andrew P.","family":"Zammit","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6329-2547","authenticated-orcid":false,"given":"Ian","family":"Brown","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"Envoi Specialist Pathologists  Brisbane Queensland Australia"},{"name":"Department of Colorectal Surgery Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1054-8486","authenticated-orcid":false,"given":"John D.","family":"Hooper","sequence":"additional","affiliation":[{"name":"Mater Research Translational Research Institute  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2065-3012","authenticated-orcid":false,"given":"David A.","family":"Clark","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Colorectal Surgery Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Mater Research Translational Research Institute  Brisbane Queensland Australia"},{"name":"Faculty of Medicine and Health University of Sydney and Surgical Outcomes Research Centre (SOuRCe)  Sydney New South Wales Australia"},{"name":"St Vincent's Private Hospital Northside  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8648-0919","authenticated-orcid":false,"given":"Andrew D.","family":"Riddell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Surgery Redcliffe Hospital  Redcliffe Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(85)90333-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-022-04142-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1570395"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2012.06320.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.01.441"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02071.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12262"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-018-1706-x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001509"},{"key":"e_1_2_9_11_1","unstructured":"Australian Bureau of Statistics.Census of Population and Housing: Socio\u2010Economic Indexes for Areas (SEIFA) 2022.https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/Lookup\/by%20Subject\/2033.0.55.001~2011~Main%20Features~Main%20Page~1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.03130.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.13502"},{"key":"e_1_2_9_14_1","first-page":"A4996","article-title":"Watchful waiting versus colorectal resection after polypectomy for malignant colorectal polyps","volume":"62","author":"Levic K","year":"2015","journal-title":"Dan. 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