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A laparoscopic approach to benign retrorectal tumors

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Abstract

Background

Retrorectal tumors (RTs) are rare in adults. Their surgical excision is often difficult because of their anatomic location. The aim of this study was to evaluate the results of straight laparoscopic resection of RTs in our institution.

Methods

Eight patients (six women and two men) with benign RTs were treated by laparoscopic resection in our tertiary care center between September 2012 and June 2013. Exclusion criteria included malignant tumors, lesions with fistula formation, and anterior sacral meningoceles. Clinical data, imaging features, operative details, pathological results, and treatment outcomes were reviewed and analyzed.

Results

Eight cases of benign RT with an average diameter of 8.9 ± 1.7 cm were treated by a straight laparoscopic procedure. The mean operative time was 122 ± 36 min, and the average intraoperative blood loss was 46 ± 33 ml. The median postoperative stay was 5 days (range 3–8 days), and all patients were discharged without serious complications. During a median follow-up of 11 months, no tumor recurrence was observed.

Conclusions

In our experience, a laparoscopic approach is safe for removing benign tumors in the retrorectal space. This approach may provide access to this difficult-to-reach space and has the advantages of allowing excellent visualization, meticulous dissection, less morbidities, and fast recuperation.

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References

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

    Article  CAS  PubMed  Google Scholar 

  2. Uhlig BE, Johnson RL (1975) Presacral tumors and cysts in adults. Dis Colon Rectum 18:581–589

    Article  CAS  PubMed  Google Scholar 

  3. McCune WS (1964) Management of sacrococcygeal tumors. Ann Surg 159:911–918

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Glasgow SC, Birnbaum EH, Lowney JK et al (2005) Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum 48:1581–1587

    Article  PubMed  Google Scholar 

  5. Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP (2005) Tumors of the retrorectal space. Dis Colon Rectum 48:1964–1974

    Article  PubMed  Google Scholar 

  6. Zhou JL, Qiu HZ (2010) Management of presacral developmental cysts: experience of 22 cases. Zhonghua Wai Ke Za Zhi 48:284–287

    PubMed  Google Scholar 

  7. Sobrado CW, Mester M, Simonsen OS, Justo CR, deAbreu JN, Habr-Gama A (1996) Retrorectal tumors complicating pregnancy. Report of two cases. Dis Colon Rectum 39:1176–1179

    Article  CAS  PubMed  Google Scholar 

  8. Dahan H, Arrive L, Wendum D, Docou le Pointe H, Djouhri H, Tubiana JM (2001) Retrorectal developmental cysts in adults: clinical and radiologic-histopathologic review, differential diagnosis, and treatment. Radiographics 21:575–584

    Article  CAS  PubMed  Google Scholar 

  9. Kalady MF, Ludwig KA (2004) Presacral developmental cysts. Semin Colon Rectal Surg 15:12–18

    Article  Google Scholar 

  10. Nair RR, Shoukrey MN, Whitlow B (2007) Presacral dermoid: now you see it now you don’t. Gynecol Surg 4:229–231

    Article  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  13. Salameh JR, Votanopoulos KI, Hilal RE et al (2002) Rectal duplication cyst in an adult: the laparoscopic approach. J Laparoendosc Adv Surg Tech A 12:453–456

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  15. Konstantinidis K, Theodoropoulos GE, Sambalis G et al (2005) Laparoscopic resection of presacral schwannomas. JSLS 15:302–304

    Google Scholar 

  16. Lopez Cano M, Vilallonga R, Espin Basany E, Sanchez Garcia JL, Lozoya Trujillo R, Armengol Carrasco M (2006) Retrorectal tumors in adults. Experience in five cases. Cir Esp 80:334–336

    Article  PubMed  Google Scholar 

  17. Chen Y, Xu H, Li Y et al (2008) Laparoscopic resection of presacral teratomas. J Minim Invasive Gynecol 15:649–651

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  19. Palanivelu C, Rangarajan M, Senthilkumar R, Madankumar MV, Annapoorni S (2008) Laparoscopic and perineal excision of an infected “dumb-bell” shaped retrorectal epidermoid cyst. J Laparoendoscopic Adv Surg Tech 8:88–92

    Article  Google Scholar 

  20. 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 

  21. Witherspoon P, Armitage J, Gatt M, Sagar PM (2010) Laparoscopic excision of retrorectal schwannoma. Dis Colon Rectum 53:101–103

    Article  CAS  PubMed  Google Scholar 

  22. 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 

  23. 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 

  24. 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 

  25. Tsutsui A, Nakamura T, Mitomi H et al (2011) Successful laparoscopic resection of a sacrococcygeal teratoma in an adult: report of a case. Surg Today 41:572–575

    Article  PubMed  Google Scholar 

  26. Nedelcu M, Andreica A, Skalli M et al (2013) Laparoscopic approach for retrorectal tumors. Surg Endosc 27:4177–4183

    Article  PubMed  Google Scholar 

  27. Duclos J, Maggiori L, Zappa M, Ferron M, Panis Y (2013) Laparoscopic resection of retrorectal tumors: a feasibility study in 12 consecutive patients. Surg Endosc PMID: 24263459

  28. Coco C, Manno A, Mattana C et al (2008) Congenital tumors of the retrorectal space in the adult: report of two cases and review of the literature. Tumori 94:602–607

    PubMed  Google Scholar 

  29. 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

    Article  CAS  PubMed  Google Scholar 

  30. Lu NH, Tseng MJ (2010) Laparoscopic management of tailgut cyst: case report and review of literature. J Minim Invasive Gynecol 17:802–804

    Article  PubMed  Google Scholar 

  31. 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 

  32. Chereau N, Lefevre JH, Meurette G et al (2013) Surgical resection of retrorectal tumours in adults: long-term results in 47 patients. Colorectal Dis 15:e476–e482

    Article  CAS  PubMed  Google Scholar 

  33. Miles RM, Stewart GS Jr (1974) Sacrococcygeal teratomas in adult. Ann Surg 179:676–683

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Geelhoed GW, Kotz HL (1983) A posterior approach to the presacral mass. World J Surg 7:620–628

    Article  CAS  PubMed  Google Scholar 

  35. Pena A, Hong A (2004) The posterior sagittal trans-sphincteric approach. Acta Chir Iugosl 51:11–21

    Article  CAS  PubMed  Google Scholar 

  36. 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

    Article  CAS  PubMed  Google Scholar 

  37. Buchs N, Taylor S, Roche B (2007) The posterior approach for low retrorectal tumors in adults. Int J Colorectal Dis 22:381–385

    Article  PubMed  Google Scholar 

  38. 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 133:473–478

    Article  PubMed  Google Scholar 

  39. 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 

  40. Dozois EJ, Jacofsky DJ, Billings BJ et al (2011) Surgical approach and oncologic outcomes following multidisciplinary management of retrorectal sarcomas. Ann Surg Oncol 18:983–988

    Article  PubMed  Google Scholar 

  41. Massimi L, Calisti A, Koutzoglou M, Di Rocco C (2003) Giant anterior sacral meningocele and posterior sagittal approach. Childs Nerv Syst 19:722–728

    Article  PubMed  Google Scholar 

  42. Villarejo F, Scavone C, Blazquez MG et al (1983) Anterior sacral meningocele: review of the literature. Surg Neurol 19:57–71

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors express their gratitude to Professor Bo Shen, who was extremely helpful and offered invaluable assistance and guidance.

Conflict of interest

Drs. Jiao-lin Zhou, Bin Wu, Yi **ao, Guo-le Lin, and Hui-zhong Qiu have undergone training programs for laparoscopic surgery in the training centers of Ethicon and Covidien, and these companies having paid for this training support. Drs. Wen-ze Wang and Guan-nan Zhang have no conflict of interests to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dong Dan, Dong Cheng District, Bei**g, 100730, China

    J. L. Zhou, B. Wu, Y. **ao, G. L. Lin, G. N. Zhang & H. Z. Qiu

  2. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Bei**g, China

    W. Z. Wang

Authors
  1. J. L. Zhou
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  2. B. Wu
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  3. Y. **ao
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  7. H. Z. Qiu
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Corresponding author

Correspondence to H. Z. Qiu.

Additional information

J. L. Zhou and B. Wu have contributed equally to this study.

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Zhou, J.L., Wu, B., **ao, Y. et al. A laparoscopic approach to benign retrorectal tumors. Tech Coloproctol 18, 825–833 (2014). https://doi.org/10.1007/s10151-014-1146-8

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  • DOI: https://doi.org/10.1007/s10151-014-1146-8

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