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Objective To assess the efficacy of hysteroscopic surgery in infertile women presenting with uterine synechiae. Design A retrospctive audit of 52 patients. Setting University hospital. Subjects A total of 52 patients presenting with intrauterine adhesions in a context of reproductive dysfunction: infertility, 29 cases; recurrent abortions, 23 cases. Interventions Operative hysteroscopy including section with scissors, lesion division, and electrosection. Results There were 34 pregnancies in 28 patients, with 24 term deliveries and 10 abortions. Conclusion Operative hysteroscopy should be considered as the primary treatment for patients with intrauterine adhesions. Hysteroscopy allows selectivity, reproducibility with little morbidity, and preserves the surrounding endometrium. After several unsuccessful procedures, abdominal surgery could be proposed.

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Operative procedures and results in the management of villous tumors of the colon and rectum are reported with an experience of 83 cases. Management of such tumors is dependable upon their morphological appearance and their location in the distal part of the large bowel, with special reference to the distance of the anal margin. Per anal local excision is the procedure of choice for pedunculated or sessile tumors located on the lower rectum, it can also be used for some midrectal locations. The transsacral approach is to be used for mid- and upper rectal tumors when the per anal approach is unsuitable. Villous carpet-like circumferential lesions require a rectal resection preserving the anal sphincter. Preoperative biopsies are not reliable for definitive histological assessment and radical surgery must not be decided on the basis of their findings. Recurrences are the consequences of incomplete excision: their management is the same as for original villous tumors.

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