The transsphincteric and transsacral approaches for the surgical excision of rectal and presacral lesions

Abstract

In the decade from 1981 to 1990, 30 patients underwent a posterior transsacral approach at the Aichi Medical University Hospital for their benign or malignant rectal lesions. The operation was classified into two procedures, consisting of the transsphincteric approach and transsacral approach, in order to cope with the condition of the anal sphincter muscles; whether they were divided or not. Eleven rectal tumors were successfully excised through the opened-up rectum by using the transsphincteric approach, and excellent results were obtained without any postoperative complications. Using the transsacral approach, 2 presacral dermoid cysts and 11 rectal lesions were easily removed under direct vision. Their prognoses were excellent. The transsacral approach was also applied for the resection of recurrent rectal cancers after a radical, abdominoperineal resection in 6 patients suffering from intolerable local symptoms. All the patients were free from these uncomfortable local symptoms after the surgery. The posterior transsacral operation is thus considered to be of value not only for resecting benign rectal and presacral lesions, but also for resecting malignant rectal tumors in frail subjects who are unfit for radical operation and/or recurrent rectal cancer.

Submucosal Dermoid Cyst of the Rectum: Report of a Case

“…Recently, the transsphincteric approach, transsacral approach, and transanal approach have been more frequently indicated for small rectal lesions below the peritoneal reflection, since early-stage rectal lesions are now more frequently found than in the past. Kanemitsu et al 14 carried out transsphincteric and transsacral approaches in 30 cases with benign and malignant rectal lesions which were inappropriate for either a radical operation and/or recurrent rectal cancer. Rectal benign lesions are particularly good indications for these approaches, only when the preoperative diagnosis as a benign rectal lesion is made.…”

Experience in treating a patient with a malignant small pelvic hemangioperocytoma

“…Опухоль может локализоваться всюду, где имеются капилляры, включая ротовую полость, средостение, за-брюшинное пространство [6].…”

Retrorectal Dermoid Cyst

“…The abdominal approach is the treatment of choice for large and highly retrorectally located lesions. The posterior approach is most useful in low lying lesions and infected cysts [2,3,[11][12][13]. Histopathologically, retrorectal cysts can be differentiated from epidermoid cysts by gross as well as microscopic analysis because they contain skin appendages (hair follicles, sweat glands, tooth buds).…”