Surgical Management of Retrorectal Tumors: A French Multicentric Experience of 270 Consecutives Cases.
Ann Surg
; 274(5): 766-772, 2021 11 01.
Article
em En
| MEDLINE
| ID: mdl-34334645
ABSTRACT
OBJECTIVE:
To report the largest multicentric experience on surgical management of retrorectal tumors (RRT).BACKGROUND:
Literature data on RRT is limited. There is no consensus concerning the best surgical approach for the management of RRT.METHODS:
Patients operated for RRT in 18 academic French centers were retrospectively included (2000-2019).RESULTS:
A 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).CONCLUSIONS:
Both 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
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Robótica
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Laparoscopia
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Laparotomia
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França