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Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: a systematic review.
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  • Aikaterini Mastoraki,
  • Ilias Giannakodimos,
  • Karmia Panagiotou,
  • Maximos Frountzas,
  • Dimosthenis Chrysikos,
  • Stylianos Kykalos,
  • Georgios Theodoropoulos,
  • Dimitrios Schizas
Aikaterini Mastoraki
National and Kapodistrian University of Athens
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Ilias Giannakodimos
National and Kapodistrian University of Athens
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Karmia Panagiotou
National and Kapodistrian University of Athens
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Maximos Frountzas
National and Kapodistrian University of Athens
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Dimosthenis Chrysikos
National and Kapodistrian University of Athens
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Stylianos Kykalos
National and Kapodistrian University of Athens
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Georgios Theodoropoulos
National and Kapodistrian University of Athens
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Dimitrios Schizas
National and Kapodistrian University of Athens
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Abstract

Background: Tailgut cysts (TGCs) are benign congenital abnormalities that usually present with non-specific symptoms, comprising a diagnostic dilemma for the physicians. The aim of this study was to systematically review the literature concerning clinical manifestations, diagnostic modalities and histologic findings of TGCs and highlight current knowledge on therapeutic management of this rare entity. Methods: PubMed and Embase databases were systematically searched by two independent investigators (last search February 18, 2021) for studies concerning TGCs published in the last two decades. Results: Totally, 144 articles, including 135 case reports and 9 case series, met our inclusion criteria. 184 patients were included (3:1/female: male) with an age of 42.3 ± 18.7 (mean, SD) years, while 5 cases concerned newborn infants. Pain was the prevailed clinical manifestation (41.8%) whereas 16.8% were asymptomatic. MRI and CT were utilized for diagnosis in 58.7% and 54.7% of cases, respectively. The majority of cysts were multilocular, while ciliated columnar epithelium and smooth muscles of the cyst wall were the prevailed histological findings. Malignant degeneration of TGCs was reported on 32.1% of cases while carcinoid tumors were the most frequent malignancies. Surgical resection was performed at 155 cases, while laparoscopic and robotic approach at 18 and 2 cases respectively. A posterior approach was implemented in 80.9%, anterior technique in 9% and combined technique in 6.7% of cases. Postoperative complications and recurrence of the cystic lesion were reported in 17.4% and 7.6% of cases, respectively. Conclusions: TGCs constitute a dilemma for the physicians. Surgical resection comprises the ultimate treatment in order to avoid complications or malignant transformation of the cyst. Further well-designed studies are needed to assess follow-up strategies and the optimal therapeutic options for TGCs.

Peer review status:UNDER REVIEW

07 Mar 2021Submitted to International Journal of Clinical Practice
11 Mar 2021Submission Checks Completed
11 Mar 2021Assigned to Editor
16 Mar 2021Reviewer(s) Assigned
10 May 2021Review(s) Completed, Editorial Evaluation Pending
17 May 20211st Revision Received
28 May 2021Submission Checks Completed
28 May 2021Assigned to Editor
28 May 2021Review(s) Completed, Editorial Evaluation Pending
28 May 2021Reviewer(s) Assigned