Sacrectomy for Primary Sacral Tumors
| Autor: | Chucheep Sahakitrungruang, Puttarat Atittharnsakul, Kraisri Chantra, Navara Dusitanond, Arun Rojanasakul |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Sacrum medicine.medical_specialty medicine.medical_treatment Nonunion Iliac Vein Osteotomy Iliac Artery Ilium Colostomy Chordoma medicine Humans Ligation Aged Retrospective Studies Giant Cell Tumor of Bone Spinal Neoplasms business.industry Gastroenterology Sacroiliac Joint Retrospective cohort study General Medicine Middle Aged musculoskeletal system medicine.disease Primary tumor Surgery Cystostomy Female Cadaveric spasm business Follow-Up Studies |
| Zdroj: | Diseases of the Colon & Rectum. 52:913-918 |
| ISSN: | 0012-3706 |
| DOI: | 10.1007/dcr.0b013e3181a0d932 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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