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Sacrectomy for primary sacral tumors.
Dis Colon Rectum. 2009 May; 52(5):913-8.DC

Abstract

PURPOSE

En bloc resection with adequate margins has provided a chance for cure of primary sacral tumors. However, high sacral lesions are challenging because of the complexity of the surgical approach. The aims of this study were to describe a modification in technique and to evaluate the outcomes.

METHODS

This is a study of eight sacrectomies performed at King Chulalongkorn Memorial Hospital between February 2000 and July 2007. Cadaveric dissections were carried out prior to surgery. We have modified the technique by ligation of the branches of the external iliac veins, resulting in "isolation" of the external iliac veins. Spinopelvic reconstruction was performed for total and extended total sacrectomy. Closure of the sacral defect was done with use of the Hartmann stump and the gluteus maximus flaps.

RESULTS

Two total sacrectomies, one extended total sacrectomy, and five subtotal S1 sacrectomies were performed. En bloc resection with adequate margins was achieved in all patients. The patient who underwent extended total sacrectomy and one patient who underwent total sacrectomy had nonunion requiring removal of the spinopelvic instrumentation. Five patients who underwent subtotal sacrectomy were ambulating well postoperatively, except for one who had an S1 fracture after falling. No sacral hernias were observed. None of the patients developed recurrence of the primary tumor. Mean follow-up time was four years.

CONCLUSIONS

Sacrectomy for primary sacral tumors can be safely conducted, achieving tumor-free margins and acceptable functional and long-term outcomes.

Authors+Show Affiliations

Department of Surgery, Colorectal Surgery Division, Chulalongkorn University, Bangkok, Thailand. chucheep@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19502856

Citation

Sahakitrungruang, Chucheep, et al. "Sacrectomy for Primary Sacral Tumors." Diseases of the Colon and Rectum, vol. 52, no. 5, 2009, pp. 913-8.
Sahakitrungruang C, Chantra K, Dusitanond N, et al. Sacrectomy for primary sacral tumors. Dis Colon Rectum. 2009;52(5):913-8.
Sahakitrungruang, C., Chantra, K., Dusitanond, N., Atittharnsakul, P., & Rojanasakul, A. (2009). Sacrectomy for primary sacral tumors. Diseases of the Colon and Rectum, 52(5), 913-8. https://doi.org/10.1007/DCR.0b013e3181a0d932
Sahakitrungruang C, et al. Sacrectomy for Primary Sacral Tumors. Dis Colon Rectum. 2009;52(5):913-8. PubMed PMID: 19502856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sacrectomy for primary sacral tumors. AU - Sahakitrungruang,Chucheep, AU - Chantra,Kraisri, AU - Dusitanond,Navara, AU - Atittharnsakul,Puttarat, AU - Rojanasakul,Arun, PY - 2009/6/9/entrez PY - 2009/6/9/pubmed PY - 2009/7/29/medline SP - 913 EP - 8 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 52 IS - 5 N2 - PURPOSE: En bloc resection with adequate margins has provided a chance for cure of primary sacral tumors. However, high sacral lesions are challenging because of the complexity of the surgical approach. The aims of this study were to describe a modification in technique and to evaluate the outcomes. METHODS: This is a study of eight sacrectomies performed at King Chulalongkorn Memorial Hospital between February 2000 and July 2007. Cadaveric dissections were carried out prior to surgery. We have modified the technique by ligation of the branches of the external iliac veins, resulting in "isolation" of the external iliac veins. Spinopelvic reconstruction was performed for total and extended total sacrectomy. Closure of the sacral defect was done with use of the Hartmann stump and the gluteus maximus flaps. RESULTS: Two total sacrectomies, one extended total sacrectomy, and five subtotal S1 sacrectomies were performed. En bloc resection with adequate margins was achieved in all patients. The patient who underwent extended total sacrectomy and one patient who underwent total sacrectomy had nonunion requiring removal of the spinopelvic instrumentation. Five patients who underwent subtotal sacrectomy were ambulating well postoperatively, except for one who had an S1 fracture after falling. No sacral hernias were observed. None of the patients developed recurrence of the primary tumor. Mean follow-up time was four years. CONCLUSIONS: Sacrectomy for primary sacral tumors can be safely conducted, achieving tumor-free margins and acceptable functional and long-term outcomes. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/19502856/Sacrectomy_for_primary_sacral_tumors_ L2 - http://dx.doi.org/10.1007/DCR.0b013e3181a0d932 DB - PRIME DP - Unbound Medicine ER -