The posterior approach for low retrorectal tumors in adults

Abstract

Retrorectal tumors are uncommon in adults and arise in different tissues in the presacral space. The aim of this study is to evaluate early complete surgical resection by a perineal approach as the therapy-of-choice for tumors under the sacral promontory. We evaluated the posterior approach, especially intersphincteric and parasacrococcygeal excisions, in terms of resectability, morbidity, risk of recurrence, and anal function. The records of all patients who underwent a posterior surgical procedure in our institution for low-lying retrorectal tumors between 1994 and 2003 were reviewed. Sixteen patients (13 women and three men) were included in this study. The age range was 21 to 57 years (median of 37 years). Pathological findings included ten tailgut cysts, three teratomas, one leiomyoma, one dermoid cyst, and one schwannoma. Complete tumor resection was obtained in 15 patients. There was one case with a microscopic residual tumor. No postoperative mortality was seen, and a minor complication occurred in one patient. There was no anal dysfunction. The postoperative course was uneventful, with only one tumor recurrence at 5 months. The median follow up was 60 months (ranging from 18 to 132 months). In this study, the posterior approach allows complete resection of low retrorectal tumors, with low morbidity, no incontinence, nearly no recurrence, and no mortality.