Surgical treatment of retrorectal tumors: a retrospective study of a ten-year experience in three institutions.

Background/aims: The relative rarity and anatomical position of retrorectal tumors may lead to difficulty in diagnosis and surgical management.

Methodology: This was a retrospective review of 93 patients who had resection of retrorectal tumors between 2002 and 2011.

Results: All patients in this study were treated with excision of the retrorectal tumors. Surgical approach included transsacral approach (78 cases), transabdominal approach (12 cases) and combined approach (3 cases). Seventy-two benign lesions (77.4%) and 21 malignant (22.6%) were confirmed by histological examination. The 72 benign cases included dermoid cysts (26 cases), simple cysts (12 cases), teratomas (12 cases), neurofibromas (12 cases), fibrolipomas (6 cases), neurilemmomas (3 cases) and synovioma (1 case). The twenty-one malignant cases included lymphomas (6 cases), malignant teratomas (5 cases), fibrosarcomas (3 cases), interstitialomas (6 cases) and malignant mesothelioma (1 case). Complications occurred in 16.1% of patients including intra-operative bleedings (6 cases), rectal injury (6 cases) and presacral infection (3 cases).

Conclusions: Primary retrorectal tumors are very rare. Successful treatment of these tumors requires extensive knowledge of pelvic anatomy and expertise in pelvic surgery.