Surgical management of retrorectal tumors: a retrospective study of a 9-year experience in a single institution

Abstract

Caizhao Lin1, Ketao Jin2,3, Huanrong Lan4, Lisong Teng2, Jianjiang Lin1, Wenbin Chen11Department of Coloproctological Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 2Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 3Department of Surgery, Affiliated Zhuji Hospital, Wenzhou Medical College, Zhuji, 4Department of Gynecology and Obstetrics, Affiliated Taizhou Hospital, Wenzhou Medical College, Linhai, Zhejiang, People’s Republic of ChinaBackground: The relative rarity and anatomical position of retrorectal tumors may lead to difficulty in diagnosis and surgical management.Methods: This was a retrospective review of 62 patients who had resection of retrorectal tumors between 2002 and 2010.Results: All patients in this study were treated by excision of the retrorectal tumors. Surgical approach included transsacral approach (52 cases), transabdominal approach (eight cases), and combined approach (two cases). A total of 48 benign lesions (77.4%) and 14 malignant lesions (22.6%) were confirmed by histological examination. The 48 benign cases included dermoid cysts (17 cases), simple cysts (eight cases), teratomas (eight cases), neurofibromas (eight cases), fibrolipomas (four cases), neurilemmomas (two cases), and synovioma (one case). The 14 malignant cases included lymphomas (four cases), malignant teratomas (three cases), fibrosarcomas (two cases), interstitialomas (four cases) and malignant mesothelioma (one case). Complications occurred in 14.5% of patients and included intraoperative bleeding (three cases), rectal injury (three cases), and presacral infection (three cases).Conclusion: Primary retrorectal tumors are very rare. Successful treatment of these tumors requires extensive knowledge of pelvic anatomy and expertise in pelvic surgery.Keywords: retrorectal space, retrorectal tumor, surgical treatment