Abstract
Background and aims
Retrorectal tumors are uncommon in adults and arise in different tissues in the presacral space. The aim of this study is to evaluate early complete surgical resection by a perineal approach as the therapy-of-choice for tumors under the sacral promontory.
Patients and methods
We evaluated the posterior approach, especially intersphincteric and parasacrococcygeal excisions, in terms of resectability, morbidity, risk of recurrence, and anal function. The records of all patients who underwent a posterior surgical procedure in our institution for low-lying retrorectal tumors between 1994 and 2003 were reviewed.
Results
Sixteen patients (13 women and three men) were included in this study. The age range was 21 to 57 years (median of 37 years). Pathological findings included ten tailgut cysts, three teratomas, one leiomyoma, one dermoid cyst, and one schwannoma. Complete tumor resection was obtained in 15 patients. There was one case with a microscopic residual tumor. No postoperative mortality was seen, and a minor complication occurred in one patient. There was no anal dysfunction. The postoperative course was uneventful, with only one tumor recurrence at 5 months. The median follow up was 60 months (ranging from 18 to 132 months).
Conclusion
In this study, the posterior approach allows complete resection of low retrorectal tumors, with low morbidity, no incontinence, nearly no recurrence, and no mortality.
Similar content being viewed by others
References
Jao SW, Beart RW, Spencer RJ, Reiman HM, Ilstrup DM (1985) Retrorectal tumors: Mayo Clinic experience, 1960–1979. Dis Colon Rectum 28:644–652
Singer MA, Cintron JR, Martz JE, Schoetz DJ, Abcarian H (2003) Retrorectal cyst: a rare tumor frequently misdiagnosed. J Am Coll Surg 196:880–886
Wolpert A, Beer-Gabel M, Lifschitz O, Zbar AP (2002) The management of presacral masses in the adult. Tech Coloproctol 6:43–49
Lev-Chelouche D, Gutman M, Goldman G, Even-Sapir E, Meller I, Issakov J et al (2003) Presacral tumors: a practical classification and treatment of a unique and heterogenous group of diseases. Surgery 133:473–478
Kolodziejski LS, Dyczek ST, Pogodzinski M (2004) Surgical management of retrorectal tumors. J Chir (Paris) 141:109–113
Roche B, Marti MC (1997) Tailgut cyst, an unusual evolution. Swiss Surg 3:21–24
Guillem P, Ernst O, Herjean M, Triboulet JP (2001) Retrorectal tumors: an assessment of the abdominal approach. Ann Chir 126:138–142
Bohm B, Milsom JW, Fazio VW, Lavery IC, Church JM, Oakley JR (1993) Our approach to the management of congenital presacral tumors in adults. Int J Colorectal Dis 8:134–138
Stewart RJ, Humphreys WG, Parks TG (1986) The presentation and management of presacral tumours. Br J Surg 73:153–155
Wang JY, Hsu CH, Changchien CR, Chen JS, Hsu KC, You YT et al (1995) Presacral tumor: a review of forty-five cases. Am Surg 61:310–315
Abel ME, Nelson R, Prasad ML, Pearl RK, Orsay CP, Abcarian H (1985) Parasacrococcygeal approach for the resection of retrorectal developmental cysts. Dis Colon Rectum 28:855–858
Bax NM, van der Zee DC (2004) The laparoscopic approach to sacrococcygeal teratomas. Surg Endosc 18:128–130
Konstantinidis K, Theodoropoulos GE, Sambalis G, Georgiou M, Vorias M, Anastassakou K et al (2005) Laparoscopic resection of presacral schwannomas. Surg Laparosc Endosc Percutan Tech 15:302–304
Pescatori M, Brusciano L, Binda GA, Serventi A (2005) A novel approach for perirectal tumours: the perianal intersphincteric excision. Int J Colorectal Dis 20:72–75
Meissner K, Jirikowski B, Szecsi T (1996) Mason paracoccygeal trans-sphincteric approach to the rectum: good outcome only in highly selective indications? Chirurg 67:145–149
Kanemitsu T, Kojima T, Yamamoto S, Koike A, Takeshige K, Naruse T (1993) The trans-sphincteric and trans-sacral approaches for the surgical excision of rectal and presacral lesions. Surg Today 23:860–866
Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP (2005) Tumors of the retrorectal space. Dis Colon Rectum 48:1964–1974
Bohm B, Milsom JW, Fazio VW, Lavery IC, Church JM, Oakley JR (1993) Our approach to the management of congenital presacral tumors in adults. Int J Colorectal Dis 8:134–138
Canessa CE (2005) Dorsal transsacrococcygeal rectal approach. Dis Colon Rectum 48:1663–1665
Pidala MJ, Eisenstat TE, Rubin RJ, Salvati EP (1999) Presacral cysts: transrectal excision in select patients. Am Surg 65:112–115
Basso L, Pescatori M (2003) Subcutaneous emphysema following associated colonoscopy and transanal excision of rectal adenoma. Surg Endosc 17:1677
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Buchs, N., Taylor, S. & Roche, B. The posterior approach for low retrorectal tumors in adults. Int J Colorectal Dis 22, 381–385 (2007). https://doi.org/10.1007/s00384-006-0183-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-006-0183-9