Retrorectal tumors are frequently resected by a posterior trans- or parasac
ral approach, while the anterior abdominal approach is generally reserved f
or small tumors situated above the sacral promontory.
Study aim: The aim of this retrospective study was to assess the use of the
abdominal approach for the treatment of large tumor masses situated in the
presacral space, and to evaluate the results in terms of resectability, mo
rbidity, and risk of recurrence.
Patients and methods: Between 1986 and 1998, six female patients (age range
: 25 to 79 years) with a retrorectal tumor (mean diameter: 7.5 cm) were ope
rated on by abdominal approach. Clinical findings, morphological and histol
ogical data, the surgical resection procedure, and post-operative morbidity
were studied.
Results: Pathological findings showed that all the tumors were benign: neur
ofibroma (n = 2), dermoid cyst (n = 1), rectal duplication (n = 1), myeloli
poma (n = 1), and epithelioid hemangioma (n = 1). Complete tumor resection
was obtained macroscopically and microscopically in all cases. The postoper
ative course was uneventful, with no tumor recurrence detected at a mean fo
llow-up of 31 months.
Conclusion: The anterior abdominal approach allows the complete resection o
f a retrorectal Targe tumor mass, and provides an interesting alternative t
o the posterior approach, with low morbidity and an absence of functional i
mpairment. (C) 2000 Editions scientifiques et medicales Elsevier SAS.