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Retrorectal Tumors: A Comprehensive Literature Review

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Affiliated Author(s)
백성규
Alternative Author(s)
Baek, Seong Kyu
Journal Title
World Journal of Surgery
ISSN
0364-2313
Issued Date
2016
Keyword
Combine ApproachPosterior ApproachAnterior ApproachChordomaNeurogenic Tumor
Abstract
Importance;

Retrorectal tumors are rare lesions that comprise a multitude of histologic types. Reports are limited to small single-institution case series, and recommendations on the ideal surgical approaches are lacking.


Objective;

The purpose of the study was to provide a comprehensive review of the epidemiology, pathologic subtypes, surgical approaches, and clinical outcomes of retrorectal tumors.


Evidence Review;

We conducted a review of the literature using PubMed and searched the reference lists of published studies.


Results
;
A total of 341 studies comprising 1708 patients were included. Overall, 68 % of patients were female. The mean age was 44.6 ± 13.7 years. Of all patients, 1194 (70 %) had benign lesions, and 514 patients (30 %) had malignant tumors. Congenital tumors (60.5 %) were the most frequent histologic type. Other pathologic types were neurogenic tumors (14.8 %), osseous tumors (3.1 %), inflammatory tumors (2.6 %), and miscellaneous tumors (19.1 %). Biopsy was performed in 27 % of the patients. Of these patients, incorrect diagnoses occurred in 44 %. An anterior surgical approach (AA) was performed in 299 patients (35 %); a posterior approach (PA) was performed in 443 (52 %), and a combined approach (CA) was performed in 119 patients (14 %). The mean length of stay (LOS) of PA was 7 ± 5 days compared to 8 ± 7 days for AA and 11 ± 7 days for CA (p < 0.05). The overall morbidity rate was 13.2 %: 19.3 % associated with anterior approach, 7.2 % associated with posterior approach, and 24.7 % after a combined approach (p < 0.05). Overall postoperative recurrence rate was 21.6 %; 6.7 % after an anterior approach, 26.6 % after a posterior approach, and 28.6 % after a combined approach (p < 0.05). A minimally invasive approach (MIS) was employed in 83 patients. MIS provided shorter hospital stays than open surgery (4 ± 2 vs. 9 ± 7 days; p < 0.05). Differences in complication rate were 19.8 % in MIS and 12.2 % in open surgery and not statistically significant.


Conclusions and Relevance;

Retrorectal tumors are most commonly benign in etiology, of a congenital nature, and have a female predominance. Complete surgical resection is the cornerstone of retrorectal tumor management. A minimal access surgery approach, when feasible, appears to be a safe option for the management of retrorectal tumors, with shorter operative time and length of stay.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine
Citation
Seong Kyu Baek et al. (2016). Retrorectal Tumors: A Comprehensive Literature Review. World Journal of Surgery, 40(8), 2001–2015. doi: 10.1007/s00268-016-3501-6
Type
Article
ISSN
0364-2313
DOI
10.1007/s00268-016-3501-6
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32865
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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