Skip to main content

Advertisement

SpringerLink
Log in

Treatment of tailgut cysts by extended distal rectal segmental resection with rectoanal anastomosis

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Complete surgical resection is the treatment of choice for tailgut cysts, because of their malignant potential and tendency to regrow if incompletely resected. We report our experience of treating patients with tailgut cysts, and discuss diagnostics, surgical approaches, and follow-up.

Methods

We performed extended distal rectal segmental resection of the tailgut cyst, with rectoanal anastomosis. We report the clinical, radiological, pathological, and surgical findings, describe the procedures performed, and summarize follow-up data.

Results

Two patients underwent en-bloc resection of a tailgut cyst, the adjacent part of the levator muscle, and the distal rectal segment, followed by an end-to-end rectoanal anastomosis. There was no evidence of anastomotic leakage postoperatively. At the time of writing, our patients were relapse-free with no, or non-limiting, symptoms of anal incontinence, respectively.

Conclusions

This surgical approach appears to have a low complication rate and good recovery outcomes. Moreover, as the sphincter is preserved, so is the postoperative anorectal function. This approach could result in a low recurrence rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Krones CJ, Peiper C, Griefingholt H, Schumpelick V. Tailgut cyst. Rare differential diagnosis of retrorectal tumors. Chirurg. 2002;73(11):1123–6.

    Article  CAS  PubMed  Google Scholar 

  2. Wolpert A, Beer-Gabel M, Lifschitz O, Zbar AP. The management of presacral masses in the adult. Tech Coloproctol. 2002;6(1):43–9.

    Article  CAS  PubMed  Google Scholar 

  3. Dahan H, Arrive L, Wendum D, Docou le Pointe H, Djouhri H, et al. Retrorectal developmental cysts in adults: clinical and radiologic–histopathologic review, differential diagnosis, and treatment. Radiographics. 2001;21(3):575–84.

    Article  CAS  PubMed  Google Scholar 

  4. Tampi C, Lotwala V, Lakdawala M, Coelho K. Retrorectal cyst hamartoma (tailgut cyst) with malignant transformation. Gynecol Oncol. 2007;105(1):266–8.

    Article  PubMed  Google Scholar 

  5. Chhabra S, Wise S, Maloney-Patel N, Rezac C, Poplin E. Adenocarcinoma associated with tail gut cyst. J Gastrointest Oncol. 2013;4(1):97–100.

    PubMed  PubMed Central  Google Scholar 

  6. Hjermstad BM, Helwig EB. Tailgut cysts. Report of 53 cases. Am J Clin Pathol. 1988;89(2):139–47.

    Article  CAS  PubMed  Google Scholar 

  7. Marco V, Autonell J, Farre J, Fernandez-Layos M, Doncel F. Retrorectal cyst-hamartomas. Report of two cases with adenocarcinoma developing in one. Am J Surg Pathol. 1982;6(8):707–14.

    Article  CAS  PubMed  Google Scholar 

  8. Mathis KL, Dozois EJ, Grewal MS, Metzger P, Larson DW, Devine RM. Malignant risk and surgical outcomes of presacral tailgut cysts. Br J Surg. 2010;97(4):575–9.

    Article  CAS  PubMed  Google Scholar 

  9. Abukar AA, Parcell BJ, Lim CB, Patil PV, Ramsanahie A, Carey F, et al. Malignancy within a tail gut cyst: a case of retrorectal carcinoid tumour. Case Rep Surg. 2014;2014:454502.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Patil P, Jibhkate SN, Pawar V, Valand A. Adenocarcinoma arising in tailgut cyst: a rare case. Indian J Pathol Microbiol. 2014;57(2):341–2.

    Article  PubMed  Google Scholar 

  11. Rammeh S, BenAbdelkrim S, Khalifa MH, Letaief R, Mokni M. Adenocarcinoma arising in a tailgut cyst: a case report. Pathologica. 2013;105(6):346–8.

    CAS  PubMed  Google Scholar 

  12. Kim JH, Jin SY, Hong SS, Lee TH. A carcinoid tumour arising within a tailgut cyst: a diagnostic challenge. Scott Med J. 2014;59(1):e14–7.

    Article  CAS  PubMed  Google Scholar 

  13. Damato A, Pusceddu S, Milione M, Mazzaferro V, Magli M, Seregni E, et al. Well-differentiated neuroendocrine tumor of tailgut cyst. A rare entity with controversial medical opportunities. Tumori. 2013;99(4):e148–51.

    PubMed  Google Scholar 

  14. Vinciguerra GL, Mercantini P, La Torre M, Pilozzi E, Ziparo V, Vecchione A. Transitional cell carcinoma of the retrorectal space arisen in tailgut cyst: a case report and review of the literature. Int J Surg Pathol. 2014;22(3):280–5.

    Article  PubMed  Google Scholar 

  15. Charalampakis V, Stamatiou D, Christodoulakis M, Kafousi M, Chryssou E, de Bree E, et al. Large presacral tailgut cyst with a carcinoid tumor in a male: report of a case. Surg Today. 2014;44(5):961–6.

    Article  PubMed  Google Scholar 

  16. Bathla L, Singh L, Agarwal PN. Retrorectal cystic hamartoma (tailgut cyst): report of a case and review of literature. Indian J Surg. 2013;75(Suppl 1):204–7.

    Article  PubMed  Google Scholar 

  17. Lev-Chelouche D, Gutman M, Goldman G, Even-Sapir E, Meller I, Issakov J, et al. Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases. Surgery. 2003;133(5):473–8.

    Article  PubMed  Google Scholar 

  18. Bullard Dunn K. Retrorectal tumors. Surg Clin North Am. 2010;90(1):163–71 (table of contents).

  19. Rosa G, Lolli P, Vergine M, El-Dalati G, Malleo G. Surgical excision of developmental retrorectal cysts: results with long-term follow-up from a single institution. Updates Surg. 2012;64(4):279–84.

    Article  PubMed  Google Scholar 

  20. Woodfield JC, Chalmers AG, Phillips N, Sagar PM. Algorithms for the surgical management of retrorectal tumours. Br J Surg. 2008;95(2):214–21.

    Article  CAS  PubMed  Google Scholar 

  21. Macafee DA, Sagar PM, El-Khoury T, Hyland R. Retrorectal tumours: optimization of surgical approach and outcome. Colorectal Dis. 2012;14(11):1411–7.

    Article  CAS  PubMed  Google Scholar 

  22. Killingsworth C, Gadacz TR. Tailgut cyst (retrorectal cystic hamartoma): report of a case and review of the literature. Am Surg. 2005;71(8):666–73.

    PubMed  Google Scholar 

  23. Au E, Anderson O, Morgan B, Alarcon L, George ML. Tailgut cysts: report of two cases. Int J Colorectal Dis. 2009;24(3):345–50.

    Article  PubMed  Google Scholar 

  24. Izant RJ Jr, Filston HC. Sacrococcygeal teratomas. Analysis of forty-three cases. Am J Surg. 1975;130(5):617–21.

    Article  PubMed  Google Scholar 

  25. Hannon J, Subramony C, Scott-Conner CE. Benign retrorectal tumors in adults: the choice of operative approach. Am Surg. 1994;60(4):267–72.

    CAS  PubMed  Google Scholar 

  26. Singer MA, Cintron JR, Martz JE, Schoetz DJ, Abcarian H. Retrorectal cyst: a rare tumor frequently misdiagnosed. J Am Coll Surg. 2003;196(6):880–6.

    Article  PubMed  Google Scholar 

  27. Kildusis E, Samalavicius NE. Surgical management of a retro-rectal cystic hamartoma (tailgut cyst) using a trans-rectal approach: a case report and review of the literature. J Med Case Rep. 2014;8:11.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Nedelcu M, Andreica A, Skalli M, Pirlet I, Guillon F, Nocca D, et al. Laparoscopic approach for retrorectal tumors. Surg Endosc. 2013;27(11):4177–83.

    Article  PubMed  Google Scholar 

  29. Chereau N, Lefevre JH, Meurette G, Mourra N, Shields C, Parc Y, et al. Surgical resection of retrorectal tumours in adults: long-term results in 47 patients. Colorectal Dis. 2013;15(8):e476–82.

    Article  CAS  PubMed  Google Scholar 

  30. Herold. Koloproktologische Klassifikation und Einteilung der Beckenbodenfunktionsstörungen. Viszeralchirurgie; 2006.

  31. Yang DM, Park CH, Jin W, Chang SK, Kim JE, Choi SJ, et al. Tailgut cyst: MRI evaluation. AJR Am J Roentgenol. 2005;184(5):1519–23.

    Article  PubMed  Google Scholar 

  32. Hasegawa S, Takahashi R, Hida K, Kawada K, Sakai Y. Transanal total mesorectal excision for rectal cancer. Surg Today. 2016;46(6):641–53.

    Article  PubMed  Google Scholar 

  33. Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien–Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46(6):668–85.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Mrs. Walter for her help and preparation of the procedure schema in Fig. 2 and Mrs. Weber for revision of the manuscript.

Author information

Authors and Affiliations

  1. Department of Visceral-, Thoracic- and Vascular Surgery, University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Andreas Volk, Hans-Detlev Saeger & Steffen Pistorius

  2. Institute of Diagnostic Radiology, University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Verena Plodeck

  3. Institute for Pathology, University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Marieta Toma

  4. University Cancer Center Dresden (UCC), University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Steffen Pistorius

Authors
  1. Andreas Volk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Verena Plodeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marieta Toma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans-Detlev Saeger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Steffen Pistorius
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steffen Pistorius.

Ethics declarations

Conflict of interest

Andreas Volk, Verena Plodeck, Marieta Toma, Hans-Detlev Saeger, and Steffen Pistorius have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Volk, A., Plodeck, V., Toma, M. et al. Treatment of tailgut cysts by extended distal rectal segmental resection with rectoanal anastomosis. Surg Today 47, 457–462 (2017). https://doi.org/10.1007/s00595-016-1403-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-016-1403-8

Keywords

Search

Navigation