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Laparoscopic resection of retrorectal tumors: a feasibility study in 12 consecutive patients

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Abstract

Background

Surgical approaches for retrorectal tumors (RRT) are either abdominal, dorsal trans-sacrococcygeal, or perineal. Very few cases have been reported so far concerning a laparoscopic approach. The aim of this study was to assess the results of laparoscopy for the treatment of RRT.

Methods

All patients who underwent laparoscopy for RRT between 2003 and 2012 were reviewed. Data included patient and tumor characteristics, surgical morbidity, and mortality.

Results

A total of 12 consecutive women with a median age of 55 years underwent laparoscopy for RRT. Median operative time was 145 min (range 70–215). Two conversions in laparotomy occurred, and one patient needed a temporary diverting ileostomy for rectal injury. Postoperatively, two patients presented urinary tract infections. Median length of stay was 8 days (range 4–16). Pathological examinations showed complete resections (R0) for ten benign tumors and one malignant tumor (Ewing sarcoma). One lesion was incompletely resected, a colloid sarcoma (R1 status), and was re-operated on by laparotomy after neoadjuvant chemoradiation. No local recurrence was observed after a median follow-up of 34 months (range 12–79) for benign lesions, and 28 and 71 months for the two patients who underwent resection of Ewing and colloid sarcoma, respectively.

Conclusions

Laparoscopic resection for RRT seems feasible and safe. It allows complete excision of tumors located in the retrorectal space with low morbidity. Thus, this approach can be a valid alternative to standard Kraske or open abdominal approaches for the treatment of RRT.

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References

  1. Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM (1985) Retrorectal tumors. Mayo Clinic experience, 1960–1979. Dis Colon Rectum 28:644–652

    Article  CAS  PubMed  Google Scholar 

  2. Glasgow SC, Birnbaum EH, Lowney JK, Fleshman JW, Kodner IJ, Mutch DG, Lewin S, Mutch MG, Dietz DW (2005) Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum 48:1581–1587

    Article  PubMed  Google Scholar 

  3. Hjermstad BM, Helwig EB (1988) Tailgut cysts. Report of 53 cases. Am J Clin Pathol 89:139–147

    CAS  PubMed  Google Scholar 

  4. Kye BH, Kim HJ, Cho HM, Chin HM, Kim JG (2011) Clinicopathological features of retrorectal tumors in adults: 9 years of experience in a single institution. J Korean Surg Soc 81:122–127

    Article  PubMed Central  PubMed  Google Scholar 

  5. Dozois EJ, Jacofsky DJ, Billings BJ, Privitera A, Cima RR, Rose PS, Sim FH, Okuno SH, Haddock MG, Harmsen WS, Inwards CY, Larson DW (2011) Surgical approach and oncologic outcomes following multidisciplinary management of retrorectal sarcomas. Ann Surg Oncol 18:983–988

    Article  PubMed  Google Scholar 

  6. Tampi C, Lotwala V, Lakdawala M, Coelho K (2007) Retrorectal cyst hamartoma (tailgut cyst) with malignant transformation. Gynecol Oncol 105:266–268

    Article  PubMed  Google Scholar 

  7. Prasad AR, Amin MB, Randolph TL, Lee CS, Ma CK (2000) Retrorectal cystic hamartoma: report of 5 cases with malignancy arising in 2. Arch Pathol Lab Med 124:725–729

    CAS  PubMed  Google Scholar 

  8. Marco V, Autonell J, Farre J, Fernandez-Layos M, Doncel F (1982) Retrorectal cyst-hamartomas. Report of two cases with adenocarcinoma developing in one. Am J Surg Pathol 6:707–714

    Article  CAS  PubMed  Google Scholar 

  9. Saygun O, Avsar FM, Topaloglu S, Yuksel BC, Ozel H, Ustun H, Hengirmen S (2003) Retrorectal benign cystic teratoma misdiagnosed with high lying pararectal abscess. Hepatogastroenterology 50(Suppl 2):cclii–ccliii

    PubMed  Google Scholar 

  10. No authors listed (1897) Kraske on cancer of the rectum. Ann Surg 26:371–381

    Google Scholar 

  11. Pappalardo G, Frattaroli FM, Casciani E, Moles N, Mascagni D, Spoletini D, Fanello G, Gualdi G (2009) Retrorectal tumors: the choice of surgical approach based on a new classification. Am Surg 75:240–248

    PubMed  Google Scholar 

  12. Marinello FG, Targarona EM, Luppi CR, Boguna I, Molet J, Trias M (2011) Laparoscopic approach to retrorectal tumors: review of the literature and report of 4 cases. Surg Laparosc Endosc Percutan Tech 21:10–13

    Article  PubMed  Google Scholar 

  13. Yang BL, Gu YF, Shao WJ, Chen HJ, Sun GD, Jin HY, Zhu X (2010) Retrorectal tumors in adults: magnetic resonance imaging findings. World J Gastroenterol 16:5822–5829

    Article  PubMed Central  PubMed  Google Scholar 

  14. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed Central  PubMed  Google Scholar 

  15. Macafee DA, Sagar PM, El-Khoury T, Hyland R (2012) Retrorectal tumours: optimization of surgical approach and outcome. Colorectal Dis 14:1411–1417

    Article  CAS  PubMed  Google Scholar 

  16. Lev-Chelouche D, Gutman M, Goldman G, Even-Sapir E, Meller I, Issakov J, Klausner JM, Rabau M (2003) Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases. Surgery 133:473–478

    Article  PubMed  Google Scholar 

  17. Woodfield JC, Chalmers AG, Phillips N, Sagar PM (2008) Algorithms for the surgical management of retrorectal tumours. Br J Surg 95:214–221

    Article  CAS  PubMed  Google Scholar 

  18. Glasgow SC, Dietz DW (2006) Retrorectal tumors. Clin Colon Rectal Surg 19:61–68

    Article  PubMed Central  PubMed  Google Scholar 

  19. Donati D, Yin J, Di Bella C, Colangeli M, Bacci G, Ferrari S, Bertoni F, Barbieri E, Mercuri M (2007) Local and distant control in non-metastatic pelvic Ewing’s sarcoma patients. J Surg Oncol 96:19–25

    Article  PubMed  Google Scholar 

  20. Jawad MU, Haleem AA, Scully SP (2011) Malignant sarcoma of the pelvic bones: treatment outcomes and prognostic factors vary by histopathology. Cancer 117:1529–1541

    Article  PubMed  Google Scholar 

  21. Sharpe LA, Van Oppen DJ (1995) Laparoscopic removal of a benign pelvic retroperitoneal dermoid cyst. J Am Assoc Gynecol Laparosc 2:223–226

    Article  CAS  PubMed  Google Scholar 

  22. Gunkova P, Martinek L, Dostalik J, Gunka I, Vavra P, Mazur M (2008) Laparoscopic approach to retrorectal cyst. World J Gastroenterol 14:6581–6583

    Article  PubMed Central  PubMed  Google Scholar 

  23. Rao M, Sagar P, Duff S, Hulme-Moir M, Brayshaw I (2010) Laparoscopic excision of a retrorectal schwannoma. Tech Coloproctol 14:353–355

    Article  CAS  PubMed  Google Scholar 

  24. Lim SW, Huh JW, Kim YJ, Kim HR (2011) Laparoscopy-assisted resection of tailgut cysts: report of a case. Case Rep Gastroenterol 5:22–27

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Melvin WS (1996) Laparoscopic resection of a pelvic schwannoma. Surg Laparosc Endosc 6:489–491

    Article  CAS  PubMed  Google Scholar 

  26. Salameh JR, Votanopoulos KI, Hilal RE, Essien FA, Williams MD, Barroso AO, Sweeney JF, Brunicardi FC (2002) Rectal duplication cyst in an adult: the laparoscopic approach. J Laparoendosc Adv Surg Tech A 12:453–456

    Article  PubMed  Google Scholar 

  27. Köhler C, Kühne-Heid R, Klemm P, Tozzi R, Schneider A (2003) Resection of presacral ganglioneurofibroma by laparoscopy. Surg Endosc 17:1499

    Article  PubMed  Google Scholar 

  28. Konstantinidis K, Theodoropoulos GE, Sambalis G, Georgiou M, Vorias M, Anastassakou K, Mpontozoglou N (2005) Laparoscopic resection of presacral schwannomas. Surg Laparosc Endosc Percutan Tech 15:302–304

    Article  PubMed  Google Scholar 

  29. Chen Y, Xu H, Li Y, Li J, Wang D, Yuan J, Liang Z (2008) Laparoscopic resection of presacral teratomas. J Minim Invasive Gynecol 15:649–651

    Article  PubMed  Google Scholar 

  30. López Cano M, Vilallonga R, Espin Basany E, Sánchez Garcia JL, Lozoya Trujillo R, Armengol Carrasco M (2006) Retrorectal tumors in adults. Experience in five cases [article in Spanish]. Cir Esp 80:334–336

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Carine Paré, clinical research associate, for her help with data retrieval and management.

Disclosures

Julie Duclos, Léon Maggiori, Magaly Zappa, Marianne Ferron, and Yves Panis have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Pôle des Maladies de l’Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Denis Diderot (Paris VII), 100 Boulevard du Général Leclerc, 92110, Clichy, France

    Julie Duclos, Léon Maggiori, Marianne Ferron & Yves Panis

  2. Department of Radiology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Denis Diderot (Paris VII), 100 Boulevard du Général Leclerc, 92110, Clichy, France

    Magaly Zappa

Authors
  1. Julie Duclos
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  2. Léon Maggiori
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  5. Yves Panis
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Corresponding author

Correspondence to Yves Panis.

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Duclos, J., Maggiori, L., Zappa, M. et al. Laparoscopic resection of retrorectal tumors: a feasibility study in 12 consecutive patients. Surg Endosc 28, 1223–1229 (2014). https://doi.org/10.1007/s00464-013-3312-x

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  • DOI: https://doi.org/10.1007/s00464-013-3312-x

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