The Treatment Efficacy of Transparasacral Approach For Presacral Tumor: A Single Center Experience

Background: Presacral tumors, also known as retrorectal tumors, locate in the presacral space and are clinically rare and the approaches for the diagnosis and treatment of presacral tumors are still deficient. The four accepted surgical approaches for presacral tumors include transabdominal approach, sacrococcygeal approach, perineal approach, and combined approach. This study aims to evaluate the treatment efficacy of transparasacral approach for presacral tumors.Methods: 23 patients (7 males and 16 females) who are diagnosed with presacral tumors and receive surgery in transsacral approach at our department were chosen. The gender, age, body mass index (BMI), and clinical symptoms were recorded. The clinical data, postoperative complications, and short and long-term rehabilitation data were recorded and analyzed. Results: The surgery was performed smoothly and the patients recovered well without signs of intestinal fistula, abdominal and pelvic infection, lung infection, organ dysfunction, or organ failure. The incision edema occurred in only one patient. In terms of the histopathological types, presacral tumors can be classified into tailgut cyst (n=10), epidermoid cyst (n=5), teratoma (n=3), and lipoma (n=10). One patient diagnosed with tailgut cyst was accompanied by adenocarcinoma transition. Tumor recurrence didn’t occur in any patients. In addition, no patients complained about dysuria, sacrococcygeal sensory disturbance, or sacrococcygeal and perineal discomfort.Conclusions: Surgical resection with transparasacral approach is effective for the treatment of presacral tumors with the advantages of high safety, good treatment efficacy, few complications, good oncological prognosis, and fast recovery.

Surgical Treatment of Benign Retrorectal Masses in Adults: A Retrospective Study

Background: Tumors that occur in the retrorectal space are called retrorectal tumors. These tumors arise from various tissues. Late symptoms may therefore outweigh diagnosis and treatment. Therefore, the surgery becomes difficult. Aims and Objectives: Our study aims to reveal the difficulties in the diagnosis of retrorectal tumors, radiological diagnostic methods, and safe surgical excision surgical techniques. Materials and Methods: Twelve patients operated for retrorectal tömür between 2014 and 2020 were included in the retrospective study. Demographic features, clinical findings, diagnostic methods, surgical treatment procedures, evaluations of preoperative/postoperative complications, pathological classifications, length of hospital stay, and duration of surgery were studied. Results: Twelve patients [9 females, 3 males; the mean age was 39.3 ± 11.8 (22-56)] due to retrorectal tumors. All lesions were evaluated preoperatively using magnetic resonance imaging (MRI). According to the preoperative examination and radiological findings; Surgical resection was performed with an anterior approach to 3 patients, a posterior approach to 4 patients, and a combined approach to 5 patients. The mean tumor size was 8 ± 2.24 cm. Immature teratoma and epidermoid cyst (n = 6) were the most common tumors. We did not have any patients with features of malignancy on final histopathology. Conclusion: Although retrorectal tumors are difficult to diagnose, it is important to suspect clinically. A good evaluation of the patients with radiological imaging facilitates the resection of the tumor surgically. Surgery of the patient in centers specialized in these tumors increases surgical success.

The Treatment Efficacy of Transparasacral Approach for Presacral Tumor: A Single Center Experience

Background Presacral tumors, also known as retrorectal tumors, locate in the presacral space and are clinically rare and the approaches for the diagnosis and treatment of presacral tumors are still deficient. The four accepted surgical approaches for presacral tumors include transabdominal approach, sacrococcygeal approach, perineal approach, and combined approach. This study aims to evaluate the treatment efficacy of transparasacral approach for presacral tumors. Methods 23 patients (7 males and 16 females) who are diagnosed with presacral tumors and receive surgery in transsacral approach at our department were chosen. The gender, age, body mass index (BMI), and clinical symptoms were recorded. The clinical data, postoperative complications, and short and long-term rehabilitation data were recorded and analyzed. Conclusions The surgery was performed smoothly and the patients recovered well without signs of intestinal fistula, abdominal and pelvic infection, lung infection, organ dysfunction, or organ failure. The incision edema occurred in only one patient. In terms of the histopathological types, presacral tumors can be classified into tailgut cyst (n = 10), epidermoid cyst (n = 5), teratoma (n = 3), and lipoma (n = 10). One patient diagnosed with tailgut cyst was accompanied by adenocarcinoma transition. Tumor recurrence didn’t occur in any patients. In addition, no patients complained about dysuria, sacrococcygeal sensory disturbance, or sacrococcygeal and perineal discomfort. Surgical resection with transparasacral approach is effective for the treatment of presacral tumors with the advantages of high safety, good treatment efficacy, few complications, good oncological prognosis, and fast recovery.

The Treatment Efficacy of Transparasacral Approach For Presacral Tumor: A Single Center Experience

Background: Presacral tumors, also known as retrorectal tumors, locate in the presacral space and are clinically rare and the approaches for the diagnosis and treatment of presacral tumors are still deficient. The four accepted surgical approaches for presacral tumors include transabdominal approach, sacrococcygeal approach, perineal approach, and combined approach. This study aims to evaluate the treatment efficacy of transparasacral approach for presacral tumors.Methods: 23 patients (7 males and 16 females) who are diagnosed with presacral tumors and receive surgery in transsacral approach at our department were chosen. The gender, age, body mass index (BMI), and clinical symptoms were recorded. The clinical data, postoperative complications, and short and long-term rehabilitation data were recorded and analyzed. Conclusions: The surgery was performed smoothly and the patients recovered well without signs of intestinal fistula, abdominal and pelvic infection, lung infection, organ dysfunction, or organ failure. The incision edema occurred in only one patient. In terms of the histopathological types, presacral tumors can be classified into tailgut cyst (n=10), epidermoid cyst (n=5), teratoma (n=3), and lipoma (n=10). One patient diagnosed with tailgut cyst was accompanied by adenocarcinoma transition. Tumor recurrence didn’t occur in any patients. In addition, no patients complained about dysuria, sacrococcygeal sensory disturbance, or sacrococcygeal and perineal discomfort. Surgical resection with transparasacral approach is effective for the treatment of presacral tumors with the advantages of high safety, good treatment efficacy, few complications, good oncological prognosis, and fast recovery.

Sacral chordoma with incidental rectal adenocarcinoma: a case report

Background We report a unique case of synchronous sacrococcygeal chordoma in association with rectal invasive adenocarcinoma. Retrorectal tumors are a rare disease caused by a variety of pathologies. To our knowledge, no prior cases of such a coincidental finding of both cancers have been reported in the literature. Case presentation This is the case of a 74-year-old white middle eastern man, with known hypertension under treatment, who presented with complaints of progressive lower back pain associated with urinary incontinence over the past 12 months. Magnetic resonance imaging (MRI) of the pelvis showed a large midline, well-defined, oval-shaped lesion replacing the sacrococcygeal portion of the spine, with extension to the presacral region. Computed tomography (CT)-guided Tru-Cut biopsy revealed features suggestive of chordoma. At surgery, we performed excision of the entire mass en bloc, sacrectomy with rectus abdominis myocutaneous flap reconstruction and end sigmoid colostomy. Surgical histopathology proved it to be sacral dedifferentiated chordoma and rectal invasive adenocarcinoma. Overall, the patient recovered well postoperatively, was discharged home with functional stoma and on permanent Foley catheter use. Conclusion To the best of our knowledge, this is the only reported case of such a presentation, and sheds light on the approach and management. We hope that reporting such a case will add value to the medical literature.