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- Title
SACRAL TUMORS: MULTIDISCIPLINARY MANAGEMENT STRATEGIES.
- Authors
Kumar, Santhosh; P. K., Rosebist
- Abstract
Background- The Multifactorial management of usually uncommon sacral tumors, either benign or malignant, is based on the pathology, extent, and local and distant spread. The standard of care is surgical wide excision. Our purpose was to manage sacral tumors by multidisciplinary approach in Govt Medical College, TVM, & to present our experiences of patients with sacral tumors treated surgically with multidisciplinary team in a tertiary care center over 5 years. methods- Our study was a retrospective review of patient records and included 9 (3 males and 6 females) who underwent sacral tumor resection with reconstruction from 2017 to 2022. The average age was 51. 4 years and the mean follow up period was 3.2 years. Data including age, sex, preop angiography, preop embolization, biopsy, approach, duration of procedure, blood loss, preop stenting, wound infection, final HPR, post op radiation, recurrence, post-op deaths were analyzed. Results: The predominant complaints were local pain and bowel and bladder. 7 patients required spino-pelvic fixation following resection. Below S2 involvement 5 cases, partial S1 and part of sacroiliac joint involvement 4 cases, extensive iliac involvement in 3 recurrent cases. Augmentation of ilio-lumbar fixation in 3 recurrent surgeries. Trans peritoneal approach 3 cases, Anterior retro peritoneal approach in 2 cases, Posterior Enbloc resection in 1 low sacral lesion. Conclusion: Large sacral tumors resection, the approach depends on the size, location, Epicenter of lesion, Anterior extension & visceral involvement, Extraosseous extension and Stability of spine. Preferred treatment is to enbloc removal of tumor with minimizing the injury or sacrificing the root. Preop biopsy to be considered. Pre-operative angiography and embolization preferred to minimize the bleeding during surgery. Spinopelvic reconstruction should be considered if there is high sacral or sacroiliac involvement.
- Subjects
SACROILIAC joint; PATIENT experience; HEALTH care teams; TUMOR surgery; THERAPEUTIC embolization; PATIENTS' attitudes; SPINAL surgery
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2024, Vol 15, Issue 5, p162
- ISSN
0975-3583
- Publication type
Article