Outcomes of Surgical Intervention for Retrorectal Tumor: Experience of Sixteen Patients in Chang Gung Memorial Hospital

Abstract

Background. Tumors originated from the retrorectal space are a rare group of diseases with diverse entities. The clinical features and surgical management of retrorectal tumors are seldom documented. Materials and Methods. Medical records of adult patients receiving resection for retrorectal tumors during 1995 and 2008 were collected. Those patients with locally advanced colorectal or gynecologic adenocarcinoma were excluded. The clinical course, pathologic findings, associated treatment, and outcomes were assessed. Results. A total of sixteen patients were included in this study, and five of them were diagnosed with malignant tumors. Benign tumors induced subtle symptoms and signs in 6 of 11 patients, while pain and other obstructive symptom were significant in malignant ones. Pelvic magnetic resonance image (MRI) and computerized tomography (CT) ascertained the diagnoses in all patients (14/14) accepting the examinations. Resections through abdominal, perineal, and combined approaches were introduced in 13, 1, and 2 patients respectively. Complete resection was achieved in 10 of 11 benign tumors but in none of malignant tumors. Teratoma, developmental cyst, and schwannoma were most common retrorectal benign tumors; on the contrary, pathologic result of retrorectal malignancies were diverse. All patients with benign tumors were disease free, except one experienced recurrence. However, all cases with malignant tumors were suffered from recurred or residual disease; three of them died within one year, whereas only one lived with disease. Conclusion. Retrorectal benign tumors are frequently asymptomatic, while retrorectal malignancies more commonly manifest pain and compression symptoms. CT and MR scans provide sufficient information for diagnosis and preoperative therapeutic plans. Benign retrorectal tumors can be cured through complete resection; however, outcomes of malignant tumors are generally unsatisfied because of scarcely complete resection.