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Article dans une revue

Surgical Management of Retrorectal Tumors A French Multicentric Experience of 270 Consecutives Cases

Mathilde Aubert 1 Diane Mege 2 Yann Parc 3 Eric Rullier 4 Eddy Cotte 5 Guillaume Meurette 6 Philippe Zerbib 7 Bertrand Trilling 8, 9 Bernard Lelong 10 Charles Sabbagh 11, 12 Zaher Lakkis 13 Mehdi Ouaissi 14 Gil Lebreton 15 Philippe Rouanet 16 Gilles Manceau 17 Jean-Jacques Tuech 18 Guillaume Piessen 7 Laurent Bresler 19 Laura Beyer-Berjot 20 Quentin Denost 4 Jeremie H. Lefevre 21 Yves Panis 22 French Res Grp Rectal Canc Surg Gr
Abstract : Objective: To report the largest multicentric experience on surgical management of retrorectal tumors (RRT). Background: Literature data on RRT is limited. There is no consensus concerning the best surgical approach for the management of RRT. Methods: Patients operated for RRT in 18 academic French centers were retrospectively included (2000-2019). Results: A total of 270 patients were included. Surgery was performed through abdominal (n = 72, 27%), bottom (n = 190, 70%), or combined approach (n = 8, 3%). Abdominal approach was laparoscopic in 53/72 (74%) and bottom approach was Kraske modified procedures in 169/190 (89%) patients. In laparoscopic abdominal group, tumors were more frequently symptomatic (37/53, 70% vs 88/169, 52%, P = 0.02), larger [mean diameter = 60.5 +/- 24 (range, 13-107) vs 51 +/- 26 (20-105) mm, P = 0.02] and located above S3 vertebra (n = 3/42, 7% vs 0%, P = 0.001) than those from Kraske modified group. Laparoscopy was associated with a higher risk of postoperative ileus (n = 4/53, 7.5% vs 0%, P = 0.002) and rectal fistula (n = 3/53, 6% vs 0%, P=0.01) but less wound abscess (n = 1/53, 2% vs 24/169, 14%, P = 0.02) than Kraske modified procedures. RRT was malignant in 8%. After a mean follow up of 27 +/- 39 (1-221) months, local recurrence was noted in 8% of the patients. After surgery, chronic pain was observed in 17% of the patients without significant difference between the 2 groups (15/74, 20% vs 3/30, 10%; P = 0.3). Conclusions: Both laparoscopic and Kraske modified approaches can be used for surgical treatment of RRT (according to their location and their size), with similar long-term results.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03566160
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Soumis le : vendredi 11 février 2022 - 13:46:06
Dernière modification le : vendredi 1 avril 2022 - 03:54:22

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Mathilde Aubert, Diane Mege, Yann Parc, Eric Rullier, Eddy Cotte, et al.. Surgical Management of Retrorectal Tumors A French Multicentric Experience of 270 Consecutives Cases. Annals of Surgery, 2021, 274 (5), pp.766-772. ⟨10.1097/SLA.0000000000005119⟩. ⟨hal-03566160⟩

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