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One-staged subtotal sacrectomy for primary sacral tumor.

Chucheep Sahakitrungruang1, Kraisri Chantra

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

Annals of Surgical Oncology
|July 1, 2009
PubMed
Summary

This study presents a modified one-staged subtotal sacrectomy technique for chordoma, achieving complete tumor resection with excellent patient recovery and no recurrence at 24 months.

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Area of Science:

  • Surgical Oncology
  • Oncologic Surgery
  • Sacral Tumor Resection

Background:

  • Sacrectomy presents surgical challenges due to complexity and morbidity.
  • A two-staged approach is often advocated for sacrectomy.
  • This study demonstrates a modified one-staged technique.

Observation:

  • A 45-year-old male with chordoma underwent a one-staged subtotal sacrectomy.
  • The procedure involved detailed steps including rectal mobilization, vessel ligation, and multi-approach osteotomies.
  • Reconstruction utilized a Hartmann stump and gluteus maximus flaps.

Findings:

  • En bloc tumor resection with clear margins was achieved.
  • The surgery required 12 hours and 6 units of blood transfusion.
  • The patient experienced a good recovery, ambulating within 1 week and walking normally within 1 month.

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  • No recurrence was observed at 24-month follow-up.

    • Implications:

    • One-staged sacrectomy is a feasible and safe approach for sacral tumors.
    • This modified technique yields satisfactory oncological and functional outcomes.
    • It offers a potentially less morbid alternative to traditional two-staged procedures.