J Korean Surg Soc.  2011 Aug;81(2):122-127. 10.4174/jkss.2011.81.2.122.

Clinicopathological features of retrorectal tumors in adults: 9 years of experience in a single institution

Affiliations
  • 1Department of Surgery, St. Vincent Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea. hmcho@catholic.ac.kr
  • 2Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Primary tumors of the retrorectal space in adults are very rare. Most of them are benign masses, but malignant masses are reported on occasion. This study aimed to investigate the clinicopathological features of retrorectal tumors.
METHODS
The medical records of fifteen patients who underwent surgical resection of a retrorectal tumor from March 2002 to April 2010 in our hospital were reviewed retrospectively.
RESULTS
Out of 15 patients, thirteen were females and two males. About 1.7 patients were diagnosed with retrorectal tumor annually in our hospital. The incidence is one per 1,500 surgeries performed under general anesthesia. An anterior approach was performed in eight patients and a posterior approach with excision of the coccyx in five patients. Combined approach was performed in two patients. Four patients (three in abdominal approach and one in combined approach) underwent laparoscopic resection. The mean size of tumors was 6.2 +/- 2.9 cm. Mature teratoma (four) and neurilemmoma (four) were the most common tumors. Except for one case of chondrosarcoma, fourteen tumors were confirmed to be of benign nature in histologic examination. Patients who underwent a transabdominal approach with laparoscopic surgery had no postoperative complication and had a tendency to experience earlier recovery than those with open surgery.
CONCLUSION
Surgical resection of a retrorectal tumor is recommended to relieve pressure symptoms and to confirm the diagnosis. A laparoscopic approach may offer excellent visualization of the deep structures in the retrorectal space, reduce surgical trauma, and be helpful for early postoperative recovery.

Keyword

Retrorectal tumor; Anterior approach; Posterior approach; Combined approach; Laparoscopy

MeSH Terms

Adult
Anesthesia, General
Chondrosarcoma
Coccyx
Female
Humans
Incidence
Laparoscopy
Male
Medical Records
Neurilemmoma
Postoperative Complications
Teratoma

Reference

1. Gordon PH. Gordon PH, Nivatvongs S, editors. Retrorectal tumors. Principles and practice of surgery of the colon, rectum, and anus. 2007. 3rd ed. New York: Informa Healthcare;353–368.
2. Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP. Tumors of the retrorectal space. Dis Colon Rectum. 2005. 48:1964–1974.
3. Wolpert A, Beer-Gabel M, Lifschitz O, Zbar AP. The management of presacral masses in the adult. Tech Coloproctol. 2002. 6:43–49.
4. Glasgow SC, Birnbaum EH, Lowney JK, Fleshman JW, Kodner IJ, Mutch DG, et al. Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum. 2005. 48:1581–1587.
5. Uhlig BE, Johnson RL. Presacral tumors and cysts in adults. Dis Colon Rectum. 1975. 18:581–589.
6. Cody HS 3rd, Marcove RC, Quan SH. Malignant retrorectal tumors: 28 years' experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum. 1981. 24:501–506.
7. Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM. Retrorectal tumors. Mayo Clinic experience, 1960-1979. Dis Colon Rectum. 1985. 28:644–652.
8. Grundfest-Broniatowski S, Marks K, Fazia VW. Fazio VW, editor. Sacral and retro rectal tumors. Current therapy in colon and rectal surgery. 1990. Toronto: BC Decker;107–115.
9. Kwon HY, Hur H, Min BS, Kim NK, Sohn SK, Cho CH. Clinicopathological features of retrorectal tumors in an adult: a case report and review of the literatures. J Korean Soc Coloproctol. 2008. 24:292–297.
10. Woodfield JC, Chalmers AG, Phillips N, Sagar PM. Algorithms for the surgical management of retrorectal tumours. Br J Surg. 2008. 95:214–221.
11. Böhm B, Milsom JW, Fazio VW, Lavery IC, Church JM, Oakley JR. Our approach to the management of congenital presacral tumors in adults. Int J Colorectal Dis. 1993. 8:134–138.
12. Localio SA, Eng K, Ranson JH. Abdominosacral approach for retrorectal tumors. Ann Surg. 1980. 191:555–560.
13. Witherspoon P, Armitage J, Gatt M, Sagar PM. Laparoscopic excision of retrorectal schwannoma. Dis Colon Rectum. 2010. 53:101–103.
14. Gunkova P, Martinek L, Dostalik J, Gunka I, Vavra P, Mazur M. Laparoscopic approach to retrorectal cyst. World J Gastroenterol. 2008. 14:6581–6583.
15. Kye BH, Kim HJ, Lee IK, Kim DH, Won DY, Kang WK, et al. Perineal reconstructive surgery of a cloaca-like perineal defect: a case report. J Korean Soc Coloproctol. 2009. 25:441–444.
Full Text Links
  • JKSS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr