Surgical management of retro-rectal tumors in the adult

Publication date: Available online 10 May 2019Source: Journal of Visceral SurgeryAuthor(s): M. Barraqué, A. Filippello, A. Brek, S. Baccot, J. Porcheron, G. BarabinoSummaryRetrorectal tumors (RRT), whether benign or malignant in nature, are rare in adults and often asymptomatic. While diagnosis is based on clinical findings, differential diagnosis depends mainly on magnetic resonance imaging (MRI). MRI provides guidance for surgical management, the first-line treatment of choice. Four surgical approaches are described: abdominal, perineal, posterior and abdomino-sacral.. This review of major reported series has made it possible to specify the indications for each surgical approach, as well as the advantages, disadvantages and complications of each one. The choice of surgical approach is determined by the nature of the RRT, its anatomical position relative to the middle of the third sacral vertebra (S3) and the presence or absence of invasion of the neighboring organs, the pelvis or sacral vertebrae. The abdominal route is chosen for tumors situated above the middle of S3, whether benign or malignant, but without invasion of neighboring organs. The perineal route is indicated for benign RRT situated below the middle of S3. The posterior route is chosen for tumors located below the middle of S3, and allows an associated resection of sacral segments in case of tumor invasion. The combined abdomino-sacral route is indicated for RRT above the middle of S3, when there is an invasi...

Source: Journal of Visceral Surgery - May 10, 2019 Category: Surgery Source Type: research