Sacrectomy for Primary Sacral Tumors

Sahakitrungruang, Chucheep; Chantra, Kraisri; Dusitanond, Navara; Atittharnsakul, Puttarat; Rojanasakul, Arun

doi:10.1007/dcr.0b013e3181a0d932

Cited by 41 publications

(33 citation statements)

References 19 publications

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“…Three cases dead during the hospitalization, another one successively for recurrence and seven patients are actually alive (four free of disease, one with persistence of the disease, two with local recurrence and one with lung metastasis); the average follow-up is 10 years and 2 months. Several authors in particular case prefer to remove the tumor by just one approach nevertheless this solution is technically more difficult so that it is suggested only for very expert surgeons [3][4][5].…”

Section: Resultsmentioning

confidence: 98%

The Gore-Tex biomaterial mesh as temporary divisor in two times surgery for spinal and pelvic tumors

et al. 2010

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In muscular skeletal spine and pelvic tumor, surgery can be performed by a double anterior and posterior approach to decrease the risk of bleeding and opening the tumor; in first one, neurovascular bundles are divided by the mass; in second one, the tumor is resected by posterior or postero-lateral approach. A Gore-Tex mesh could be used as divisor between neurovascular bundles and the tumor to decrease the adhesion formation risk and facilitate tumor removal during second operation if performed after more days. The cohort was composed by a consecutive series of 11 patients underwent to surgery for spine and pelvic tumor where Gore-Tex mesh spacer was placed. In this study, efficiency and tolerability of Gore-Tex mesh were evaluated. No case of adhesion between Gore-Tex mesh and surrounding structures is reported, no case of migration or complications occurred. Gore-Tex mesh use can be considered a useful and safe procedure to decrease the risk of adhesion formation between tumor and surrounding tissue so that to allow the tumor removal easier.

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Section: Resultsmentioning

confidence: 98%

The Gore-Tex biomaterial mesh as temporary divisor in two times surgery for spinal and pelvic tumors

et al. 2010

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“…Many authors have reported a mean intraoperative blood loss greater than 6000 ml, making it difficult to achieve wide resection due to an obstructed view, and leading to hemorrhagic shock and death. 14,25,28,32 Preoperative selective embolization of sacral tumors has proved to be an effective method for minimizing intraoperative blood loss, which will improve the safety of the operation and the resectability of sacral tumors. 27,43 We also applied an aortic balloon to decrease intraoperative blood loss, by inserting it into the abdominal artery via femoral access.…”

Section: Discussionmentioning

confidence: 99%

Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors?

Zang

Guo

Yang

et al. 2015

SPI

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OBJECT In this study the authors' aim was to describe their experience with total en bloc sacrectomy using a posterioronly approach and to assess the outcome of patients with malignant sacral tumors who underwent this procedure at their center. METHODS The authors identified and retrospectively reviewed the records of 10 patients with malignant sacral tumors who underwent a total en bloc sacrectomy via a single posterior approach at their center. The pathological diagnosis was chordoma in 4 patients, chondrosarcoma in 1, osteosarcoma in 1, malignant schwannoma in 1, malignant giant cell tumor in 1, and Ewing's sarcoma in 2. Radiological examination revealed that the tumor involved S1–5 in 7 patients, S1–4 in 1, S1–3 in 1, and S1–2 in 1. RESULTS All 10 patients were stable during the perioperative period. The mean surgery duration was 282 minutes (range 250–310 minutes). The median estimated blood loss was 2595 ml (range 1500–3200 ml). All patients were followed up for 13–29 months (mean 22 months). Two patients had a local recurrence. Two patients died of disease, 1 patient was alive with disease, and 7 patients were alive without evidence of disease. Among the 8 surviving patients, 6 were able to walk without assistive devices, and 2 were able to walk with crutches. The total complication rate was 40% (4 of 10). Wound complications (deep infection and wound healing problems) occurred in 3 patients, and a distal deep vein thrombosis occurred in 1 patient. CONCLUSIONS Total en bloc sacrectomy using a posterior-only approach is feasible and safe in selected patients and is an important procedure for the treatment of primary malignant tumor involving the entire sacrum or only the top portion.

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“…In contrast, in another observational study of 60 patients, the average number of transfused units was 5.2; however, these patients underwent preoperative tumor embolization [140]. It is important to note that the highest number of PRBCs transfused was in patients undergoing hemisacrectomies, with 75% of them receiving 10 or more units of blood [134,139]. Thus, massive blood transfusions are common in patients undergoing sacrectomies.…”

Section: Oncological Spine and Sacral Surgerymentioning

confidence: 96%

“…A few authors have successfully utilized aortic balloon occlusion to avoid significant bleeding [46,137,138]. Others have reported encouraging results with preoperative tumor embolization, ligation of both internal iliac vessels, and staged surgery [139][140][141].…”

Section: Oncological Spine and Sacral Surgerymentioning

confidence: 99%

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Cata

Gottumukkala

2012

ISRN Anesthesiology

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Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive oncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state; however, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant drugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication of all complex oncological surgeries is massive intra-and postoperative hemorrhage and the subsequent risk for massive blood transfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor embolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to prevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is largely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus, recommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.

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Sacrectomy for Primary Sacral Tumors

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

Cited by 41 publications

References 19 publications

The Gore-Tex biomaterial mesh as temporary divisor in two times surgery for spinal and pelvic tumors

The Gore-Tex biomaterial mesh as temporary divisor in two times surgery for spinal and pelvic tumors

Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors?

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

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