| Zhong Fang,Wei Wu,Wei Xiong,Guanghui Li,Hui Liao,Jun Xiao,Fengjing Guo,Anmin Chen,Feng Li. Single-stage en bloc resection using a posterior approach for sacral tumors. Oncol Transl Med, 2016, 2: 65-68. |
| Single-stage en bloc resection using a posterior approach for sacral tumors |
| Received:January 27, 2016 Revised:April 10, 2016 |
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| KeyWord:sacrum; tumor; en bloc resection; spinal cord compression; reconstruction |
| Author Name | Affiliation | E-mail | | Zhong Fang | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | 33759625@qq.com | | Wei Wu | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Wei Xiong | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Guanghui Li | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Hui Liao | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Jun Xiao | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Fengjing Guo | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Anmin Chen | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | wuweisheit@hotmail.com | | Feng Li | Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | lifengmd@hust.edu.cn |
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| Abstract: |
| Objective?This study aims to investigate the surgical results of single-stage en bloc resections using a posterior approach for sacral tumors and evaluate its benefit for these tumors.
Methods?A total of 32 cases involving patients with sacral tumors who were treated with single-stage en bloc resection by posterior approach from April 2004 to January 2010 were reviewed. The patient cohort included 20 males and 12 females. The average patient age was 49.1 years old (range, 18 to 75 years old). Twenty-seven patients suffered from primary sacral tumors, including 17 patients with chordomas, 5 patients with giant cell tumors of the bone, 3 patients with chondrosarcoma, 1 patient with sarcoma of the nerve fibers, and 1 patient with neurofibromatosis. Five patients were diagnosed with sacral metastatic tumors, including 2 cases of breast cancer, 1 case of renal carcinoma, 1 case of thyroid cancer, and 1 case of lung cancer. According to the Frankel grading system, there were 3 Grade B tumors, 4 Grade C tumors, 10 Grade D tumors, and 15 Grade E tumors.
Results?The operation took 265 min on average (range, 130–360?min), and blood loss was 1676 mL on average (range, 800–1800 mL) during the operation. The follow-up period ranged from 6 months to 6.2 years. All patients had pain prior to operation. Twenty-eight patients experienced complete pain-relief, and 4 patients experienced partial pain-relief after their operations. In all patients, neurological function was improved more than one grade using the Frankel grading system. Up to now, 5 patients experienced local recurrence after operation, and 2 patients were deceased. The remaining patients are still alive without recurrence.
Conclusion?Single-stage en bloc resection through a posterior approach for sacral tumors is feasible, safe, and effective. It has many advantages, such as controlling local recurrence, thorough decompression of the spinal cord, relieving pain, improving quality of life, and prolonging survival.
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