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Navigating the Depths: Anesthetic Challenges in Sacrectomy.

Rohini Dattatri¹, Mahima Gupta²

¹Department of Trauma and Emergency, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh 522503 India.

Indian Journal of Surgical Oncology

|June 1, 2026

Summary

Anesthetic management for sacrectomy, especially for giant cell tumors, poses unique challenges. Enhanced recovery after surgery (ERAS) principles can optimize patient outcomes and reduce complications.

Keywords:

Anesthesia Blood loss Enhanced recovery after surgery Giant cell tumor Postoperative pain Sacrum

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Area of Science:

Anesthesiology
Surgical Oncology
Oncology

Background:

Sacrectomy, the surgical removal of the sacrum, presents significant anesthetic challenges.
These challenges include extensive resection, prolonged duration, substantial blood loss, hemodynamic instability, metabolic disturbances, positioning issues, and complex pain management.
Giant cell tumors (GCTs) of the sacrum add unique complexities to this already demanding procedure.

Purpose of the Study:

To report a case of sacrectomy for a giant cell tumor of the sacrum.
To highlight the unique anesthetic challenges encountered in this rare procedure.
To provide insights into optimizing anesthetic strategies for improved recovery and reduced perioperative morbidity.

Main Methods:

Case report detailing the anesthetic management of a patient undergoing sacrectomy for a GCT of the sacrum.
Integration of enhanced recovery after surgery (ERAS) principles into the anesthetic plan.
Focus on mitigating homeostatic disturbances and the stress response.

Main Results:

Successful anesthetic management was achieved by addressing the unique challenges.
The application of ERAS principles contributed to mitigating perioperative complications.
The case provides valuable learning points for future anesthetic strategies in similar scenarios.

Conclusions:

Sacrectomy for sacral GCTs requires meticulous anesthetic planning and execution.
Enhanced recovery after surgery (ERAS) protocols are crucial for optimizing outcomes.
Further research and case reports are needed to refine anesthetic management for rare oncological surgeries.