Dashti Mohamad Hosein, Zeinalpour Adel, Nikshoar Mohammad Reza, Hashempour Mohammad Reza, Ariapour Alireza, Pishgahi Mohammad, Sadeghi Amir, Anaraki Firooz Fakhry Alsadat
Colorectal Devision of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2025;14(2):56-62. doi: 10.61186/wjps.14.2.56.
Retrorectal tumors are rare, heterogeneous neoplasms in the pararectal space that have low incidence, nonspecific symptoms, and variable presentations; they are often challenging to diagnose and manage, necessitating high clinical suspicion. We evaluated the clinical characteristics, diagnostic challenges, surgical outcomes, and postoperative follow-up of patients with retrorectal tumors treated over 12 years.
A retrospective case series was conducted on 34 patients who underwent surgery for retrorectal tumors at Taleghani Hospital, Tehran, Iran, from 2011 to 2023. Clinical presentations, imaging findings, surgical interventions, histopathological diagnoses, and postoperative outcomes were analyzed.
Thirty-four patients with 37 lesions were included, with a mean age of 40.21 ± 11.57 years. The majority of patients were female (88.2%). Pelvic pain was the most common symptom (44.1%), followed by rectal pain (38.2%). The retrorectal space was the most frequently affected location (67.6%). Most tumors were cystic (51.4%), with congenital tumors being the most common histopathological subtype (37.8%). Malignancy was identified in 29.7% of cases. The most frequent surgical approach was total resection via the posterior approach (55.9%), followed by the anterior approach (26.5%). Postoperative recurrence requiring secondary surgery was observed in 5.9% of patients.
Due to their rarity and diverse presentations, retrorectal tumors pose significant diagnostic and surgical challenges. Preoperative imaging plays a critical role in diagnosis and surgical planning. Complete surgical excision remains the mainstay of treatment, and recurrence is rare. Multidisciplinary collaboration is essential for optimizing patient outcomes.
直肠后肿瘤是直肠旁间隙罕见的异质性肿瘤，发病率低，症状不特异，表现多样；其诊断和管理往往具有挑战性，需要高度的临床怀疑。我们评估了12年来接受治疗的直肠后肿瘤患者的临床特征、诊断挑战、手术结果及术后随访情况。
对2011年至2023年在伊朗德黑兰塔莱加尼医院接受直肠后肿瘤手术的34例患者进行回顾性病例系列研究。分析临床表现、影像学检查结果、手术干预、组织病理学诊断及术后结果。
纳入34例患者共37个病灶，平均年龄40.21±11.57岁。大多数患者为女性（88.2%）。盆腔疼痛是最常见症状（44.1%），其次是直肠疼痛（38.2%）。直肠后间隙是最常受累部位（67.6%）。大多数肿瘤为囊性（51.4%），先天性肿瘤是最常见的组织病理学亚型（37.8%）。29.7%的病例确诊为恶性肿瘤。最常用的手术入路是经后路全切除术（55.9%），其次是前路手术（26.5%）。5.9%的患者术后复发需要二次手术。
由于直肠后肿瘤罕见且表现多样，其诊断和手术具有重大挑战。术前影像学检查在诊断和手术规划中起关键作用。完整的手术切除仍是主要治疗方法，复发罕见。多学科协作对于优化患者预后至关重要。
