Retrorectal tumors are frequently resected by a posterior trans- or parasacral approach, while the anterior abdominal approach is generally reserved for small tumors situated above the sacral promontory.
Study aim: The aim of this retrospective study was to assess the use of the abdominal approach for the treatment of large tumor masses situated in the presacral space, and to evaluate the results in terms of resectability, morbidity, and risk of recurrence.
Patients and methods: Between 1986 and 1998, six female patients (age range: 25 to 79 years) with a retrorectal tumor (mean diameter: 7.5 cm) were operated on by abdominal approach. Clinical findings, morphological and histological data, the surgical resection procedure, and post-operative morbidity were studied.
Results: Pathological findings showed that all the tumors were benign: neurofibroma (n = 2), dermoid cyst (n = 1), rectal duplication (n = 1), myelolipoma (n = 1), and epithelioid hemangioma (n = 1). Complete tumor resection was obtained macroscopically and microscopically in all cases. The postoperative course was uneventful, with no tumor recurrence detected at a mean follow-up of 31 months.
Conclusion: The anterior abdominal approach allows the complete resection of a retrorectal large tumor mass, and provides an interesting alternative to the posterior approach, with low morbidity and an absence of functional impairment.