Laparoscopic approach to retrorectal tumors: review of the literature and report of 4 cases

Abstract

Background: Retrorectal or presacral tumors are extremely rare and their histologic origin varies greatly. Surgical excision is indicated to prevent complications or to rule out malignancy. A laparoscopic approach has been infrequently reported to date. The aim of this article is to report our experience in 4 cases, and to review the current world experience on laparoscopic approach to retrorectal tumors.

Methods: Between 1998 and 2009, we operated 4 cases in which a presacral tumor was diagnosed. A pure laparoscopic procedure was performed in 3 cases and a combined laparoscopic/transacral approach in a fourth. In addition, a systematic literature review and relevant reports on laparoscopic approach of these tumors were analyzed.

Results: All patients underwent laparoscopic dissection of the tumor with extraction through a Phannestiel incision except in 1 case that was performed transsacrally. Simultaneously, the literature review showed 11 articles with a total number of 18 patients approached by laparoscopy.

Conclusions: The laparoscopic approach of retrorectal tumors is feasible. The advantages are an enhanced access and visualization of the pelvic structures and a more controlled preservation of nerve and vascular integrity. It seems to be a safe procedure and can be combined with a posterior approach if needed.