Wide rectal duplication cyst in an adult resected by anterior approach: efficacy and recurrence

Abstract

Alimentary tract duplications are uncommon congenital abnormalities usually diagnosed and treated in childhood. Rectal involvement is extremely rare. We report the case of a 22-year-old female who presented with chronic abdominal and perianal pain; feeling of rectal fullness. Workup revealed a rectal duplication cyst. The patient underwent a complete transabdominal excision of the cyst: an hybrid laparoscopic and laparotomic technique was adopted. The hybrid isolated anterior abdominal approach is safe and feasible even for the treatment of wide rectal duplication cysts. Real recurrence in rectal duplication cysts is uncommon when the first operation was performed with radical intent.

Rectal duplication cyst mimicking rectal prolapse: A case report

“…Computed tomography (CT) and magnetic resonance imaging (MRI), although less often used, are helpful in localizing and diagnosing complex duplications. [7][8][9] To conclude, rectal duplication simulating rectal prolapse is a rare entity. Every case of rectal prolapse should be examined carefully to rule out such anomalies.…”

Rectal duplication cyst in an adult with a history of imperforate anus: a diagnostic challenge

“…Second, surgical resection of the rectal duplication eliminates the otherwise persistent risk of complications, such as bleeding, perforation and malignant degeneration 7–9. Several surgical techniques have been previously described in the literature for the treatment of rectal duplications, including parasacral, transanal, perianal and abdominal approaches 18–28. The size and location of the lesion, along with surgeon’s experience should be considered when choosing the operative technique, for there is no consensus about the best surgical approach 9 29–31.…”

“…Transanal excision may be convenient for small low-lying rectal duplications but can be technically challenging 20–22. The anterior abdominal approach (open or laparoscopic) allows complete resection of large lesions located either posteriorly or anteriorly to the rectum with little morbidity,23–29 and, if an anterior rectal resection is necessary, it can be performed from that same approach 26. Given the anterior location of the lesion, its large size and surgeon’s expertise, the laparoscopic approach was considered adequate to completely remove the lesion.…”

A case report of adult rectal duplication cyst resected by synchronous trans-abdominal and trans-anal total mesorectal excision

“…However, TME sometimes could not be success due to narrow pelvis, obese, and large tumor [ 5 ]. Moreover, surgical resection of sometimes difficult because of anatomical site and dealings: posteriority the sacral vessels; laterally the hypogastric plexus and its branch; anteriority the prostate or vagina [ 18 ]. Several approaches were reported by trans abdominal, trans-anal, trans coccygeal, and posterior sagittal approach [ 12 , 19 ].…”