Sagar A J, Tan W S, Codd R, Fong S S, Sagar P M
The John Goligher Colorectal Unit, St. James University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Tech Coloproctol. 2014 Nov;18(11):1023-7. doi: 10.1007/s10151-014-1172-6. Epub 2014 Jun 14.
The aim of this study was to review a consecutive series of patients who had undergone excision of recurrent retrorectal tumours and propose surgical strategies to tackle such recurrences.
Patients were identified from a prospectively maintained database. Demographic details, preoperative imaging and pathology, intra- and post-operative problems and follow-up details were noted.
Fifteen patients (11 females) with a median age of 38 years (range 19-75 years) underwent excision of recurrent retrorectal tumours (13 benign) between 2002 and 2012. The median interval between the first and second surgical procedure was 3.5 years (range 1-19 years). Three patients had surgery performed via the transperineal approach, while 12 patients had resection via the abdominal approach. En bloc resection of adjacent organs was needed in three patients. Major pelvic bleeding occurred in two patients. R0 resection was achieved in all 15 patients, and there have been no subsequent recurrences [median follow-up 73 months (range 12-148 months)].
Benign recurrent retrorectal tumours can be safely excised usually without sacrifice of adjacent organs, while en bloc resection is needed for malignant tumours.
本研究旨在回顾一系列连续接受复发性直肠后肿瘤切除术的患者，并提出应对此类复发的手术策略。
从一个前瞻性维护的数据库中识别患者。记录人口统计学细节、术前影像学和病理学、术中和术后问题以及随访细节。
2002年至2012年间，15例患者（11例女性）接受了复发性直肠后肿瘤切除术（13例为良性），中位年龄38岁（范围19 - 75岁）。首次和第二次手术之间的中位间隔时间为3.5年（范围1 - 19年）。3例患者经会阴途径手术，12例患者经腹部途径切除。3例患者需要整块切除相邻器官。2例患者发生严重盆腔出血。所有15例患者均实现R0切除，且无后续复发[中位随访73个月（范围12 - 148个月）]。
良性复发性直肠后肿瘤通常可安全切除，一般无需切除相邻器官，而恶性肿瘤则需要整块切除。
