Retrorectal or presacral tumors are rare lesions located in the presacral area and considered as being derived from multiple embryological remnants.These tumors are classified as congenital,neurogenic,osseous,inflamma...Retrorectal or presacral tumors are rare lesions located in the presacral area and considered as being derived from multiple embryological remnants.These tumors are classified as congenital,neurogenic,osseous,inflammatory,or miscellaneous.The most common among these are congenital benign lesions that present with non-specific symptoms,such as lower back pain and change in bowel habit.Although congenital and developmental tumors occur in younger patients,the median age of presentation is reported to be 45 years.Magnetic resonance imaging plays a crucial role in treatment management through accurate diagnosis of the lesion,the evaluation of invasion to adjacent structures,and the decision of appropriate surgical approach.The usefulness of preoperative biopsy is still debated;currently,it is only indicated for solid or heterogeneous tumors if it will alter the treatment management.Surgical resection with clear margins is considered the optimal treatment;described approaches are transabdominal,perineal,combined abdominoperineal,and minimally invasive.Benign retrorectal tumors have favorable long-term outcomes with a low incidence of recurrence,whereas malignant tumors have a potential for distant organ metastasis in addition to local recurrence.展开更多
Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually be...Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually benign,currently believed to arise from aberrant embryogenesis.Presacral cysts are clinically rare and the true incidence is unknown.Surgical resection remains the major treatment for presacral cysts.Unless the cysts are completely resected,recurrence is unavoidable.Recurrent cysts or hard-to-heal sinuses in the sacrococcyx cause patients extreme pain.However,the current knowledge of presacral cysts is insufficient.They are occasionally confused with other diseases such as ovarian cysts and perianal abscesses.Moreover,lack of the correct surgical concept and skills leads to palliative treatment for complex presacral cysts and serious complications such as impairing the function of the anal sphincter or important blood vessels and nerves.The consensus summarizes the opinions and experiences of multidisciplinary experts in presacral cysts and aims to provide clinicians with a more defined concept of the treatment,standardize the surgical approach,and improve the efficacy of presacral cysts.展开更多
文摘Retrorectal or presacral tumors are rare lesions located in the presacral area and considered as being derived from multiple embryological remnants.These tumors are classified as congenital,neurogenic,osseous,inflammatory,or miscellaneous.The most common among these are congenital benign lesions that present with non-specific symptoms,such as lower back pain and change in bowel habit.Although congenital and developmental tumors occur in younger patients,the median age of presentation is reported to be 45 years.Magnetic resonance imaging plays a crucial role in treatment management through accurate diagnosis of the lesion,the evaluation of invasion to adjacent structures,and the decision of appropriate surgical approach.The usefulness of preoperative biopsy is still debated;currently,it is only indicated for solid or heterogeneous tumors if it will alter the treatment management.Surgical resection with clear margins is considered the optimal treatment;described approaches are transabdominal,perineal,combined abdominoperineal,and minimally invasive.Benign retrorectal tumors have favorable long-term outcomes with a low incidence of recurrence,whereas malignant tumors have a potential for distant organ metastasis in addition to local recurrence.
文摘Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually benign,currently believed to arise from aberrant embryogenesis.Presacral cysts are clinically rare and the true incidence is unknown.Surgical resection remains the major treatment for presacral cysts.Unless the cysts are completely resected,recurrence is unavoidable.Recurrent cysts or hard-to-heal sinuses in the sacrococcyx cause patients extreme pain.However,the current knowledge of presacral cysts is insufficient.They are occasionally confused with other diseases such as ovarian cysts and perianal abscesses.Moreover,lack of the correct surgical concept and skills leads to palliative treatment for complex presacral cysts and serious complications such as impairing the function of the anal sphincter or important blood vessels and nerves.The consensus summarizes the opinions and experiences of multidisciplinary experts in presacral cysts and aims to provide clinicians with a more defined concept of the treatment,standardize the surgical approach,and improve the efficacy of presacral cysts.
