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直肠后肿瘤:单中心10年经验

Retrorectal tumor: a single-center 10-years' experience.

作者信息

Yalav Orçun, Topal Uğur, Eray İsmail Cem, Deveci Mehmet Ali, Gencel Eyüphan, Rencuzogullari Ahmet

机构信息

Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.

Department of Orthopedics and Traumatology, Çukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Ann Surg Treat Res. 2020 Aug;99(2):110-117. doi: 10.4174/astr.2020.99.2.110. Epub 2020 Jul 31.

DOI:10.4174/astr.2020.99.2.110
PMID:32802816
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7406398/
Abstract

PURPOSE

Retrorectal tumors (RTs) are a rare incidence and recommendations on the ideal surgical approaches are lacking. This study aimed to evaluate outcomes and follow-up results of patients undergoing excision of RTs at our institution.

METHODS

A retrospective review was conducted for undergoing surgery for RT between January 2009 and January 2019. Demographic characteristics, presenting symptoms, preoperative diagnostic tests, surgical procedures, histopathological results, intraoperative and postoperative complications, postoperative hospital stay, postoperative 30-day mortality, 90-day unplanned readmission rate, and long-term outcomes were evaluated.

RESULTS

Twenty patients with a mean age of 48.3 ± 14.2 were analyzed. The most common presenting complaint was perineal pain (35.0%). Magnetic resonance imaging and computed tomography was preferred in 18 and 2 patients, respectively. Tumor localization was below the level of the third sacral vertebrae in 14 patients for whom the posterior surgical approach was used. No postoperative mortality was recorded at the end of follow-up of 53.8 ± 40 months. Mean length of postoperative hospital stay was 8.6 ± 9.4 days. Ten percent of the patients had unplanned hospital readmission within 90 days after discharge. Recurrence developed in 1 patient, for whom pathology were reported as chordoma.

CONCLUSION

RT should be managed by a multidisciplinary team given the complexity and heterogeneity of these tumors despite the fact that the majority are benign. A good understanding of pelvic anatomy and characterization of lesions through detailed radiological imaging is crucial to optimize surgical planning. Complete surgical resection is key for prolonged disease-free and overall survival of patients diagnosed with RTs.

摘要

目的

直肠后肿瘤(RTs)发病率罕见,目前缺乏关于理想手术方式的建议。本研究旨在评估在我院接受RTs切除手术患者的治疗效果及随访结果。

方法

对2009年1月至2019年1月期间接受RTs手术的患者进行回顾性分析。评估患者的人口统计学特征、临床表现、术前诊断检查、手术方式、组织病理学结果、术中及术后并发症、术后住院时间、术后30天死亡率、90天非计划再入院率以及长期预后。

结果

分析了20例患者,平均年龄为48.3±14.2岁。最常见的主诉是会阴部疼痛(35.0%)。分别有18例和2例患者首选磁共振成像和计算机断层扫描。14例肿瘤位于第三骶椎水平以下的患者采用了后路手术方式。在平均53.8±40个月的随访结束时,未记录到术后死亡病例。术后平均住院时间为8.6±9.4天。10%的患者在出院后90天内出现非计划再次入院。1例患者复发,其病理报告为脊索瘤。

结论

鉴于这些肿瘤的复杂性和异质性,尽管大多数为良性,RTs仍应由多学科团队进行管理。通过详细的影像学检查充分了解盆腔解剖结构和病变特征对于优化手术规划至关重要。完整的手术切除是确诊为RTs患者延长无病生存期和总生存期的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/d14a92dbb7b7/astr-99-110-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/56f88915f1ef/astr-99-110-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/bba877853bfc/astr-99-110-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/afaf6c2093a3/astr-99-110-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/d14a92dbb7b7/astr-99-110-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/56f88915f1ef/astr-99-110-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/bba877853bfc/astr-99-110-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/afaf6c2093a3/astr-99-110-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6c/7406398/d14a92dbb7b7/astr-99-110-g004.jpg

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