Evolution of the management of retrorectal masses: A retrospective cohort study

• Published in: Colorectal disease 2021-11, Vol.23 (11), p.2988-2998
• Main Authors: Gould, Laura E., Pring, Edward T., Corr, Alison, Fletcher, Jordan, Warusavitarne, Janindra, Burling, David, Northover, John M. A., Jenkins, John T.
• Format: Article
• Language: English
• Subjects: Algorithms; Anorectal; Asymptomatic; Chronic pain; Cohort analysis; Complications; congenital cysts; developmental cyst; Female; Humans; Invasiveness; Male; Malignancy; Management; Middle Aged; Morbidity; Pain; Patients; presacral; Rectal Neoplasms - diagnosis; Rectal Neoplasms - surgery; retrorectal; Retrospective Studies; Wound healing
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.15893

Aim Retrorectal masses are abnormalities located anatomically in the retrorectal space. A significant proportion are asymptomatic with no malignant potential while others cause symptoms due to mechanical pressure or malignant infiltration. We reviewed and categorised the retrorectal masses encountered over a 30‐year time period in a specialist colorectal hospital and describe our management algorithm for consideration by other multidisciplinary teams (MDT). Methods This was a retrospective analysis of consecutive patients referred between 1984–2019. A detailed review of clinical presentation, imaging features, postoperative histology and impact on morbidity and anorectal function is reported. Results A total of 143 patients with median age of 46 years and female preponderance (74%) were reviewed. The commonest presenting symptom was pain (46%) and all malignant cases had symptoms (n = 17). Over the last decade, more asymptomatic patients have presented with a retrorectal mass (33%, p = 0.04) and more patients are opting for surveillance rather than resection (33%, p = 0.013). Increasing age and lesion size were associated with malignancy (p