• Annals of surgery · Nov 2021

    Multicenter Study

    Surgical Management of Retrorectal Tumors: A French Multicentric Experience of 270 Consecutives Cases.

    • Mathilde Aubert, Diane Mege, Yann Parc, Eric Rullier, Eddy Cotte, Guillaume Meurette, Philippe Zerbib, Bertrand Trilling, Bernard Lelong, Charles Sabbagh, Zaher Lakkis, Mehdi Ouaissi, Gil Lebreton, Philippe Rouanet, Gilles Manceau, Jean-Jacques Tuech, Guillaume Piessen, Laurent Bresler, Laura Beyer-Berjot, Quentin Denost, Jérémie H Lefèvre, Yves Panis, and French Research Group of Rectal Cancer Surgery (GRECCAR).
    • Assistance Publique Hôpitaux de Marseille, Timone Hospital, Marseille, France.
    • Ann. Surg. 2021 Nov 1; 274 (5): 766-772.

    ObjectiveTo report the largest multicentric experience on surgical management of retrorectal tumors (RRT).BackgroundLiterature data on RRT is limited. There is no consensus concerning the best surgical approach for the management of RRT.MethodsPatients operated for RRT in 18 academic French centers were retrospectively included (2000-2019).ResultsA total of 270 patients were included. Surgery was performed through abdominal (n = 72, 27%), bottom (n = 190, 70%), or combined approach (n = 8, 3%). Abdominal approach was laparoscopic in 53/72 (74%) and bottom approach was Kraske modified procedures in 169/190 (89%) patients. In laparoscopic abdominal group, tumors were more frequently symptomatic (37/53, 70% vs 88/169, 52%, P = 0.02), larger [mean diameter = 60.5 ± 24 (range, 13-107) vs 51 ± 26 (20-105) mm, P = 0.02] and located above S3 vertebra (n = 3/42, 7% vs 0%, P = 0.001) than those from Kraske modified group. Laparoscopy was associated with a higher risk of postoperative ileus (n = 4/53, 7.5% vs 0%, P = 0.002) and rectal fistula (n = 3/53, 6% vs 0%, P=0.01) but less wound abscess (n = 1/53, 2% vs 24/169, 14%, P = 0.02) than Kraske modified procedures. RRT was malignant in 8%. After a mean follow up of 27 ±39 (1-221) months, local recurrence was noted in 8% of the patients. After surgery, chronic pain was observed in 17% of the patients without significant difference between the 2 groups (15/74, 20% vs 3/30, 10%; P = 0.3).ConclusionsBoth laparoscopic and Kraske modified approaches can be used for surgical treatment of RRT (according to their location and their size), with similar long-term results.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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