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.

Citations

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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

The Unresolved Case of Sacral Chordoma: From Misdiagnosis to Challenging Surgery and Medical Therapy Resistance: Fabio Garofalo, Dimitrios Christoforidis, Pietro G. di Summa, Béatrice Gay, Stéphane Cherix, Wassim Raffoul, Nicolas Demartines, Maurice Matter; Ann Coloproctol. 2014;30(3):122-131. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.122

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Abstract PDF

Purpose

A sacral chordoma is a rare, slow-growing, primary bone tumor, arising from embryonic notochordal remnants. Radical surgery is the only hope for cure. The aim of our present study is to analyse our experience with the challenging treatment of this rare tumor, to review current treatment modalities and to assess the outcome based on R status.

Methods

Eight patients were treated in our institution between 2001 and 2011. All patients were discussed by a multidisciplinary tumor board, and an en bloc surgical resection by posterior perineal access only or by combined anterior/posterior accesses was planned based on tumor extension.

Results

Seven patients underwent radical surgery, and one was treated by using local cryotherapy alone due to low performance status. Three misdiagnosed patients had primary surgery at another hospital with R1 margins. Reresection margins in our institution were R1 in two and R0 in one, and all three recurred. Four patients were primarily operated on at our institution and had en bloc surgery with R0 resection margins. One had local recurrence after 18 months. The overall morbidity rate was 86% (6/7 patients) and was mostly related to the perineal wound. Overall, 3 out of 7 resected patients were disease-free at a median follow-up of 2.9 years (range, 1.6-8.0 years).

Conclusion

Our experience confirms the importance of early correct diagnosis and of an R0 resection for a sacral chordoma invading pelvic structures. It is a rare disease that requires a challenging multidisciplinary treatment, which should ideally be performed in a tertiary referral center.

Citations

Citations to this article as recorded by

Gas Plasma Technology and Immunogenic Cell Death: Implications for Chordoma Treatment
Sander Bekeschus, Karl Roessler, Oliver Kepp, Eric Freund
Cancers.2025; 17(4): 681. CrossRef
Comparison of combined anterior–posterior and posterior-only approaches for lumbosacral chordomas: a systematic review and meta-analysis of surgical and clinical outcomes
Quintino Giorgio D’Alessandris, Martina Offi, Valerio Maria Caccavella, Martina Giordano, Eduardo Fernandez, Liverana Lauretti, Roberto Pallini, Alessandro Olivi, Nicola Montano
Neurosurgical Review.2022; 45(3): 2005. CrossRef
Behandlungsalternativen für sakrale Chordome
Darius Kalasauskas, Florian Ringel
Die Wirbelsäule.2022; 06(04): 233. CrossRef
Durable Response of Spinal Chordoma to Combined Inhibition of IGF-1R and EGFR
Tamara Aleksic, Lisa Browning, Martha Woodward, Rachel Phillips, Suzanne Page, Shirley Henderson, Nicholas Athanasou, Olaf Ansorge, Duncan Whitwell, Sarah Pratap, A. Bassim Hassan, Mark R. Middleton, Valentine M. Macaulay
Frontiers in Oncology.2016;[Epub] CrossRef
Multidisciplinary approach of lumbo‐sacral chordoma: From oncological treatment to reconstructive surgery
Fabio Garofalo, Pietro G. di Summa, Dimitrios Christoforidis, Marc Pracht, Pietro Laudato, Stéphane Cherix, Hanan Bouchaab, Wassim Raffoul, Nicolas Demartines, Maurice Matter
Journal of Surgical Oncology.2015; 112(5): 544. CrossRef
Sacral Chordoma: Challenging for Resection Margin
Seung-Hyun Lee, Byung-Kwon Ahn
Annals of Coloproctology.2014; 30(3): 104. CrossRef

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