Skip to main content
Top
Published in: Techniques in Coloproctology 11/2014

01-11-2014 | Original Article

Surgical strategies in the management of recurrent retrorectal tumours

Authors: A. J. Sagar, W. S. Tan, R. Codd, S. S. Fong, P. M. Sagar

Published in: Techniques in Coloproctology | Issue 11/2014

Login to get access

Abstract

Background

The aim of this study was to review a consecutive series of patients who had undergone excision of recurrent retrorectal tumours and propose surgical strategies to tackle such recurrences.

Methods

Patients were identified from a prospectively maintained database. Demographic details, preoperative imaging and pathology, intra- and post-operative problems and follow-up details were noted.

Results

Fifteen patients (11 females) with a median age of 38 years (range 19–75 years) underwent excision of recurrent retrorectal tumours (13 benign) between 2002 and 2012. The median interval between the first and second surgical procedure was 3.5 years (range 1–19 years). Three patients had surgery performed via the transperineal approach, while 12 patients had resection via the abdominal approach. En bloc resection of adjacent organs was needed in three patients. Major pelvic bleeding occurred in two patients. R0 resection was achieved in all 15 patients, and there have been no subsequent recurrences [median follow-up 73 months (range 12–148 months)].

Conclusions

Benign recurrent retrorectal tumours can be safely excised usually without sacrifice of adjacent organs, while en bloc resection is needed for malignant tumours.
Literature
1.
go back to reference Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM (1985) Retrorectal tumors. Mayo clinic experience, 1960–1979. Dis Colon Rectum 28:644–652PubMedCrossRef Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM (1985) Retrorectal tumors. Mayo clinic experience, 1960–1979. Dis Colon Rectum 28:644–652PubMedCrossRef
2.
go back to reference Glasgow SC, Birnbaum EH, Lowney JK et al (2005) Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum 48:1581–1587PubMedCrossRef Glasgow SC, Birnbaum EH, Lowney JK et al (2005) Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum 48:1581–1587PubMedCrossRef
3.
go back to reference Singer MA, Cintron JR, Martz JE, Schoetz DJ, Abcarian H (2003) Retrorectal cyst: a rare tumor frequently misdiagnosed. J Am Coll Surg 196:880–886PubMedCrossRef Singer MA, Cintron JR, Martz JE, Schoetz DJ, Abcarian H (2003) Retrorectal cyst: a rare tumor frequently misdiagnosed. J Am Coll Surg 196:880–886PubMedCrossRef
4.
go back to reference Woodfield JC, Chalmers AG, Phillips N, Sagar PM (2008) Algorithms for the surgical management of retrorectal tumours. Br J Surg 95:214–221PubMedCrossRef Woodfield JC, Chalmers AG, Phillips N, Sagar PM (2008) Algorithms for the surgical management of retrorectal tumours. Br J Surg 95:214–221PubMedCrossRef
5.
go back to reference Pappalardo G, Frattaroli FM, Casciani E et al (2009) Retrorectal tumors: the choice of surgical approach based on a new classification. Am Surg 75:240–248PubMed Pappalardo G, Frattaroli FM, Casciani E et al (2009) Retrorectal tumors: the choice of surgical approach based on a new classification. Am Surg 75:240–248PubMed
7.
go back to reference Chereau N, Lefevre JH, Meurette G et al (2013) Surgical resection of retrorectal tumors in adults: long term results in 47 patients. Colorectal Dis 15:e476–e482PubMedCrossRef Chereau N, Lefevre JH, Meurette G et al (2013) Surgical resection of retrorectal tumors in adults: long term results in 47 patients. Colorectal Dis 15:e476–e482PubMedCrossRef
8.
go back to reference Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP (2005) Tumors of the retrorectal space. Dis Colon Rectum 48:1964–1974PubMedCrossRef Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP (2005) Tumors of the retrorectal space. Dis Colon Rectum 48:1964–1974PubMedCrossRef
9.
go back to reference Merchea A, Larson DW, Hubner M, Wenger DE, Rose PS, Dozois EJ (2013) The value of preoperative biopsy in the management of solid presacral tumors. Dis Colon Rectum 56:756–760PubMedCrossRef Merchea A, Larson DW, Hubner M, Wenger DE, Rose PS, Dozois EJ (2013) The value of preoperative biopsy in the management of solid presacral tumors. Dis Colon Rectum 56:756–760PubMedCrossRef
10.
go back to reference Macafee DA, Sagar PM, El-Khoury T, Hyland R (2012) Retrorectal tumours: optimization of surgical approach and outcome. Colorectal Dis 14:1411–1417PubMedCrossRef Macafee DA, Sagar PM, El-Khoury T, Hyland R (2012) Retrorectal tumours: optimization of surgical approach and outcome. Colorectal Dis 14:1411–1417PubMedCrossRef
11.
go back to reference Wolpert A, Beer-Gabel M, Lifschitz O, Zbar AP (2002) The management of presacral masses in the adult. Tech Coloproctol 6:43–49PubMedCrossRef Wolpert A, Beer-Gabel M, Lifschitz O, Zbar AP (2002) The management of presacral masses in the adult. Tech Coloproctol 6:43–49PubMedCrossRef
12.
go back to reference Wang JY, Hsu CH, Changchien CR et al (1995) Presacral tumor: a review of forty-five cases. Am Surg 61:310–315PubMed Wang JY, Hsu CH, Changchien CR et al (1995) Presacral tumor: a review of forty-five cases. Am Surg 61:310–315PubMed
13.
go back to reference Hjermstad BM, Helwig EB (1988) Tailgut cysts. Report of 53 cases. Am J Clin Pathol 89:139–147PubMed Hjermstad BM, Helwig EB (1988) Tailgut cysts. Report of 53 cases. Am J Clin Pathol 89:139–147PubMed
14.
go back to reference Grandjean JP, Mantion GA, Guinier D et al (2008) Vestigial retrorectal cystic tumors in adults: a review of 30 cases. Gastroenterol Clin Biol 32:769–778PubMedCrossRef Grandjean JP, Mantion GA, Guinier D et al (2008) Vestigial retrorectal cystic tumors in adults: a review of 30 cases. Gastroenterol Clin Biol 32:769–778PubMedCrossRef
15.
go back to reference Lev-Chelouche D, Gutman M, Goldman G et al (2003) Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases. Surgery 133:473–478PubMedCrossRef Lev-Chelouche D, Gutman M, Goldman G et al (2003) Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases. Surgery 133:473–478PubMedCrossRef
16.
go back to reference Buchs N, Taylor S, Roche B (2007) The posterior approach for low retrorectal tumors in adults. Int J Colorectal Dis 22:381–385PubMedCrossRef Buchs N, Taylor S, Roche B (2007) The posterior approach for low retrorectal tumors in adults. Int J Colorectal Dis 22:381–385PubMedCrossRef
17.
go back to reference 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 8:134–138PubMedCrossRef 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 8:134–138PubMedCrossRef
Metadata
Title
Surgical strategies in the management of recurrent retrorectal tumours
Authors
A. J. Sagar
W. S. Tan
R. Codd
S. S. Fong
P. M. Sagar
Publication date
01-11-2014
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 11/2014
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-014-1172-6

Other articles of this Issue 11/2014

Techniques in Coloproctology 11/2014 Go to the issue