Retrorectal cystic hamartoma (hindgut cyst) is a rare developmental lesion arising from the vestiges of the embryonic hind gut. Other developmental cysts can occur in retrorectal space. Anal gland cysts can develop near the anal sphincter. All these cysts are similar to retrorectal cystic hamartoma and their exact diagnosis depends on the histopathological examination including immunohistochemical profile. Retrorectal cysts are asymptomatic in 50% of the cases and the lesion is an incidental finding.
A research team led by Petra Gunkova from the Faculty Hospital Ostrava of Czech reported their experience with two female patients who were diagnosed as retrorectal cyst and were managed using laparoscopic approach. This will be published on November 12, 2008 in the World Journal of Gastroenterology.
The two symptomatic patients were operated laparoscopically. After peritoneal insufflation the pressure was maintained at 11 mmHg. The site, size and distribution of the trocars used were as follows: 10 mm umbilical trocar for camera. For the surgeon working hands a 12 mm trocar in the right hypogastrium and a 5 mm trocar in the right mesogastrium For the assistance; a 10 mm trocar in the left hypogastrium and a 5 mm trocar in the left mesogastrium. The retrorectal space was opened using harmonic scalpel at the sacral promontory level, the mesorectum was dissected free and the cystic lesion was identified. The cyst was resected using harmonic scalpel after its complete dissection and seperation from the surrounding structures. The pelvic floor was reconstructed by suture and a drain was placed in the Douglas pouch. The total operation time was 75 min for the first case and 90 min for the second case.
They concluded that laparoscopic excision of retrorectal systs is a safe and efficient option. Laparoscopic approach minimizes the surgical trauma and offers perfect visualization of the deep structures in the presacral space.
Reference: Gunkova P, Martinek L, Dostalik J, Gunka I, Vavra P, Mazur M. Laparoscopic approach to retrorectal cyst. World J Gastroenterol 2008; 14(42): 6581-6583 http://www.wjgnet.com/1007-9327/14/6581.asp
Correspondence to: Petra Gunkova, MD, the Faculty Hospital Ostrava, 17. listopadu 1790, Ostrava Poruba 70800, Czech Republic. firstname.lastname@example.org Telephone: +420-597-375052 Fax: +420-597-375054
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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