Progress in the management of retrorectal tumours

Hopper, Laura Rose; Eglinton, Tim; Wakeman, Christopher; Dobbs, B. R.; Dixon, Liane; Frizelle, Frank

doi:10.1111/codi.13117

Cited by 32 publications

(25 citation statements)

References 21 publications

(35 reference statements)

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“…Although recent studies such as that by Hopper et al . have demonstrated that cystic lesions may be managed non‐operatively, the present review suggests that provided the patient is fit for surgery benign lesions should be resected. This is because a benign lesion can be complicated by infection and cause compression of the presacral nerves or obstructive symptoms and vague abdominal discomfort.…”

Section: Discussionmentioning

confidence: 77%

Management approach and surgical strategies for retrorectal tumours: a systematic review

Toh

Morgan

2016

Colorectal Disease

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Section: Discussionmentioning

confidence: 77%

Management approach and surgical strategies for retrorectal tumours: a systematic review

Toh

Morgan

2016

Colorectal Disease

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“…As another result of this study, the specificity of distinguishing between benign or malignant disease by imaging method was 81% and sensitivity was 83% [15]. In another study, it was concluded that it could be helpful in the diagnosis of Ewing's sarcoma, neurofibrosarcoma, or desmoid tumor, which may receive benefits from preoperative biopsy and neoadjuvant therapy [10,16]. More importantly, a careless transrectal needle biopsy of meningocele can cause undesirable consequences such as meningitis, and even subsequent death [17].…”

Section: Discussionmentioning

confidence: 62%

“…The most common imaging modalities are CT and MRI [10,11]. MRI is preferred over CT because it predicts benign or malignant characteristics of the tumor.…”

Section: Discussionmentioning

confidence: 99%

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Retrorectal tumor: a single-center 10-years' experience

et al. 2020

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Purpose: Retrorectal tumors (RTs) are a rare incidence and recommendations on the ideal surgical approaches are lacking. This study aimed to evaluate outcomes and follow-up results of patients undergoing excision of RTs at our institution. Methods: A retrospective review was conducted for undergoing surgery for RT between January 2009 and January 2019. Demographic characteristics, presenting symptoms, preoperative diagnostic tests, surgical procedures, histopathological results, intraoperative and postoperative complications, postoperative hospital stay, postoperative 30-day mortality, 90-day unplanned readmission rate, and long-term outcomes were evaluated. Results: Twenty patients with a mean age of 48.3 ± 14.2 were analyzed. The most common presenting complaint was perineal pain (35.0%). Magnetic resonance imaging and computed tomography was preferred in 18 and 2 patients, respectively. Tumor localization was below the level of the third sacral vertebrae in 14 patients for whom the posterior surgical approach was used. No postoperative mortality was recorded at the end of follow-up of 53.8 ± 40 months. Mean length of postoperative hospital stay was 8.6 ± 9.4 days. Ten percent of the patients had unplanned hospital readmission within 90 days after discharge. Recurrence developed in 1 patient, for whom pathology were reported as chordoma. Conclusion: RT should be managed by a multidisciplinary team given the complexity and heterogeneity of these tumors despite the fact that the majority are benign. A good understanding of pelvic anatomy and characterization of lesions through detailed radiological imaging is crucial to optimize surgical planning. Complete surgical resection is key for prolonged disease-free and overall survival of patients diagnosed with RTs.

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“…They demonstrated a 95% sensitivity for differentiating benign from malignant tumors with the MRI. They also performed a biopsy only to the solid lesions, performing surgery only to 27 of the 65 lesions highlighting the importance of the MRI in the management of this lesion [8].…”

Section: Discussionmentioning

confidence: 99%

Surgical Excision of Ischiorectal Fossa Tumors

Trill¹,

Garcı́a²,

Moreno³

et al. 2016

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Background: Ischiorectal Fossa Tumors are rare and their management has not been protocolized. Patients: We retrospectively review four consecutive cases treated in our department, from January 2015 to July 2015. All of them were discussed in a multidisciplinary team meeting. None of them were secondary to an inflammatory process. Results: A Magnetic Resonance Imaging was performed in all the four patients, and as it was not a malignant diagnosis made in any of them, we proceeded to resecate the lesions. None biopsies were performed and the benign diagnoses were confirmed by the pathologist. All the patients underwent a local posterior or perineal approach, because all the lesions (epidermoid cyst, hamartoma, lipoma and an aggressive angiomyxoma) were localized purely in the ischiorectal fossa, under the levator ani muscle and not invading any adjacent structures. In all of them, an R0 resection was performed. Conclusions: Ischiorectal fossa tumors are rare and there are few cases already published. Non-inflammatory lesions located in the ischiorectal fossa, with none invasion of rectum or levator ani muscle, are mainly benign lesions prone to their complete excision by a posterior approach. Biopsy is not always necessary unless there's a suspicion of a malignancy or invasion of adjacent structures, and only in that case a biopsy should be made, because in some of them, a neo-adjuvant treatment can be useful to reduce the tumor and to perform an R0 resection.

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Progress in the management of retrorectal tumours

Cited by 32 publications

References 21 publications

Management approach and surgical strategies for retrorectal tumours: a systematic review

Management approach and surgical strategies for retrorectal tumours: a systematic review

Retrorectal tumor: a single-center 10-years' experience

Surgical Excision of Ischiorectal Fossa Tumors

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