Annals of Coloproctology

Original Articles

Surgical management of retrorectal tumors: a single-center 12 years’ experience: Amirhosein Naseri, Behnam Behboudi, Ali Faryabi, Seyed Mohsen Ahmadi Tafti, Amirsina Sharifi, Mohammad Reza Keramati, Mohammad Sadegh Fazeli, Amir Keshvari, Mehdi Zeinalizadeh, Reza Akbari Asbagh, Niloufar Hoorshad, Alireza Kazemeini; Received April 26, 2022 Accepted June 23, 2022 Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00297.0042 [Epub ahead of print]

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Purpose
Retrorectal tumors (RTs) are rare tumors that arise in the space between the mesorectum and the pelvic wall and often originate in embryonic tissues. The primary treatment for these tumors is complete excision surgery, and choosing the best surgical approach is very important.
Methods
In this study, we retrospectively collected the data of 15 patients with RTs who underwent surgery in Imam Khomeini Hospital (Tehran, Iran) for 12 years to share our experiences of patients’ treatment and compare different surgical approaches.
Results
A total of 5 tumors were malignant, 10 were benign, and most of the tumors were congenital. Malignant tumors were seen in older patients. Three surgical procedures were performed on patients. Three patients underwent abdominal approach surgery, and 8 patients underwent posterior surgery. A combined surgical approach was performed on 4 patients. Two patients underwent laparoscopic surgery. The abdominal approach had the least long-term complication, and the combined approach had the most complications; laparoscopic surgery reduced the length of hospital stay and complications after surgery.
Conclusion
A multidisciplinary team collaboration using magnetic resonance imaging details is necessary to determine a surgical treatment approach. It could reduce the need for a preoperative biopsy. However, every approach has its advantages and disadvantages, and individualized treatment is the key.

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Tailgut Cyst—Gynecologist’s Pitfall: Literature Review and Case Report
Andrei Mihai Malutan, Viorela-Elena Suciu, Florin Laurentiu Ignat, Doru Diculescu, Razvan Ciortea, Emil-Claudiu Boțan, Carmen Elena Bucuri, Maria Patricia Roman, Ionel Nati, Cristina Ormindean, Dan Mihu
Diagnostics.2025; 15(1): 108. CrossRef

Malignant disease, Rectal cancer, Functional outcomes

Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection: Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti; Ann Coloproctol. 2022;38(3):230-234. Published online June 10, 2021; DOI: https://doi.org/10.3393/ac.2021.00059.0008

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Abstract PDF

Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

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Citations to this article as recorded by

Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
Updates in Surgery.2023; 75(4): 847. CrossRef
Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates
F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
British Journal of Surgery.2022;[Epub] CrossRef
Outpatient closure in a late colo-cutaneous postoperative anastomotic leak managed with EVAC in Bucaramanga, Colombia. Case report.
Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
International Journal of Surgery Case Reports.2022; 100: 107737. CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef

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