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Total sacrectomy and reconstruction: oncologic and functional outcome
P Wuisman1, O Lieshout, S Sugihara
1Department of Orthopaedic Surgery, University Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
Clinical Orthopaedics and Related Research
|December 29, 2000
Summary
Total sacrectomy offers valuable tumor control and survival for sacral tumors. Despite complications, this procedure is effective for managing challenging oncologic cases.
Area of Science:
- Oncology
- Surgical Oncology
- Orthopedic Oncology
Background:
- Sacral tumors present complex surgical challenges.
- Total sacrectomy is a radical approach for managing these tumors.
Purpose of the Study:
- To review oncologic and functional outcomes of patients undergoing total sacrectomy.
- To evaluate the efficacy and complications of total sacrectomy for sacral tumors.
Main Methods:
- Retrospective review of nine patients treated with total sacrectomy (L5 or L5-S1).
- Histologic diagnoses included osteosarcoma, giant cell tumors, chondrosarcomas, and chordomas.
- Analysis of resection margins, reconstruction methods, complications, and survival rates.
Main Results:
- Six patients had wide resection margins; two had intralesional margins.
- Wound complications (dehiscence, infection) occurred in 45.5% of patients, requiring reintervention.
- 33% of patients died within 50 months due to recurrence or metastases; six patients were disease-free at follow-up.
Conclusions:
- Total sacrectomy is a valuable procedure for achieving local tumor control and improving survival for sacral tumors.
- The procedure is associated with significant morbidity, including wound complications and potential hernia formation.
- Functional outcomes did not correlate with the use of reconstruction methods.