TY - JOUR
T1 - A systematic review of minimally invasive surgery for retrorectal tumors
AU - Mullaney, T. G.
AU - Lightner, A. L.
AU - Johnston, M.
AU - Kelley, S. R.
AU - Larson, D. W.
AU - Dozois, E. J.
N1 - Publisher Copyright:
© 2018, Springer International Publishing AG, part of Springer Nature.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients (≥ 18 years) had a minimally invasive approach (laparoscopic or robotic) for resection of a primary retrorectal tumor were included. Data were collected on approach, preoperative investigation, size and sacral level of the tumor, operating time, length of stay, perioperative complications, margins and recurrence. Thirty-five articles which included a total of 82 patients met the inclusion criteria. The majority of patients were female (n = 65; 79.2%), with a mean age of 41.7 years (range 18–89 years). Seventy-three patients (89.0%) underwent laparoscopic or combined laparoscopic–perineal resection, and 9 (10.8%) had a robotic approach. The conversion rate was 5.5%. The overall 30-day morbidity rate was 15.7%, including 1 intraoperative rectal injury (1.2%). Ninety-five percent (n = 78) of the retrorectal tumors were benign. Median length of stay was 4 days for both laparoscopic and robotic groups, with ranges of 1–8 and 2–10 days, respectively. No tumor recurrence was noted during follow-up [median 28 months (range 5–71 months)]. A minimally invasive approach for the resection of retrorectal tumors is feasible in selected patients. Careful patient selection is necessary to avoid incomplete resection and higher morbidity than traditional approaches.
AB - Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients (≥ 18 years) had a minimally invasive approach (laparoscopic or robotic) for resection of a primary retrorectal tumor were included. Data were collected on approach, preoperative investigation, size and sacral level of the tumor, operating time, length of stay, perioperative complications, margins and recurrence. Thirty-five articles which included a total of 82 patients met the inclusion criteria. The majority of patients were female (n = 65; 79.2%), with a mean age of 41.7 years (range 18–89 years). Seventy-three patients (89.0%) underwent laparoscopic or combined laparoscopic–perineal resection, and 9 (10.8%) had a robotic approach. The conversion rate was 5.5%. The overall 30-day morbidity rate was 15.7%, including 1 intraoperative rectal injury (1.2%). Ninety-five percent (n = 78) of the retrorectal tumors were benign. Median length of stay was 4 days for both laparoscopic and robotic groups, with ranges of 1–8 and 2–10 days, respectively. No tumor recurrence was noted during follow-up [median 28 months (range 5–71 months)]. A minimally invasive approach for the resection of retrorectal tumors is feasible in selected patients. Careful patient selection is necessary to avoid incomplete resection and higher morbidity than traditional approaches.
KW - Colorectal/anal neoplasia
KW - Laparoscopic
KW - Minimally invasive surgery
KW - Retrorectal tumors
KW - Robotic
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U2 - 10.1007/s10151-018-1781-6
DO - 10.1007/s10151-018-1781-6
M3 - Review article
C2 - 29679245
AN - SCOPUS:85045731721
SN - 1123-6337
VL - 22
SP - 255
EP - 263
JO - Techniques in Coloproctology
JF - Techniques in Coloproctology
IS - 4
ER -