title: Surgical strategies in the management of recurrent retrorectal tumours.
abstract: BACKGROUND
  The aim of this study was to review a consecutive series of patients who had undergone excision of recurrent retrorectal tumours and propose surgical strategies to tackle such recurrences.
  
  
  METHODS
  Patients were identified from a prospectively maintained database. Demographic details, preoperative imaging and pathology, intra- and post-operative problems and follow-up details were noted.
  
  
  RESULTS
  Fifteen patients (11 females) with a median age of 38 years (range 19-75 years) underwent excision of recurrent retrorectal tumours (13 benign) between 2002 and 2012. The median interval between the first and second surgical procedure was 3.5 years (range 1-19 years). Three patients had surgery performed via the transperineal approach, while 12 patients had resection via the abdominal approach. En bloc resection of adjacent organs was needed in three patients. Major pelvic bleeding occurred in two patients. R0 resection was achieved in all 15 patients, and there have been no subsequent recurrences [median follow-up 73 months (range 12-148 months)].
  
  
  CONCLUSIONS
  Benign recurrent retrorectal tumours can be safely excised usually without sacrifice of adjacent organs, while en bloc resection is needed for malignant tumours.
authors.affiliation: The John Goligher Colorectal Unit, St. James University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Sagar
authors.forename: W S
authors.initials: WS
authors.lastname: Tan
authors.forename: R
authors.initials: R
authors.lastname: Codd
authors.forename: S S
authors.initials: SS
authors.lastname: Fong
authors.forename: P M
authors.initials: PM
authors.lastname: Sagar
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult