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Sacrectomy for primary sacral tumors.

Chucheep Sahakitrungruang¹, Kraisri Chantra, Navara Dusitanond

¹Department of Surgery, Colorectal Surgery Division, Chulalongkorn University, Bangkok, Thailand. chucheep@hotmail.com

Diseases of the Colon and Rectum

|June 9, 2009

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This study modified sacrectomy techniques for high sacral tumors, achieving tumor-free margins. Outcomes were acceptable, with most patients ambulating well post-surgery.

Area of Science:

Surgical oncology
Orthopedic surgery
Sacral tumor resection

Background:

En bloc resection with adequate margins offers a chance for cure in primary sacral tumors.
High sacral lesions present significant surgical challenges due to complex approaches.

Purpose of the Study:

To describe a modified surgical technique for high sacral lesions.
To evaluate the outcomes of this modified sacrectomy technique.

Main Methods:

Eight sacrectomies were performed between 2000 and 2007.
A modified technique involved ligation of external iliac vein branches for "isolation".
Spinopelvic reconstruction and defect closure with Hartmann stump and gluteus maximus flaps were utilized.

Main Results:

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En bloc resection with adequate margins was achieved in all eight patients.
Two total sacrectomies, one extended total sacrectomy, and five subtotal S1 sacrectomies were performed.
No recurrence or sacral hernias were observed; mean follow-up was four years.

Conclusions:

Sacrectomy for primary sacral tumors can be safely performed.
The modified technique achieves tumor-free margins.
Acceptable functional and long-term outcomes are achievable with this approach.