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HOME > J Korean Soc Coloproctol > Volume 26(3); 2010 > Article
Original Article
Trans-Sacral Local Resection as a Posterior Approach.
Lee, Bong Hwa , Park, Hyoung Chul , Lee, Hae Wan , An, Chang Nam , Um, Taeik , Lim, Young A , Kim, Byoung Sup , Chang, Mi Young , Kim, Soo Hyoung , Cho, Sung Wook
Journal of the Korean Society of Coloproctology 2010;26(3):197-203
DOI: https://doi.org/10.3393/jksc.2010.26.3.197
1Department of Surgery, Hallym University College of Medicine, Anyang, Korea. bshlee@hallym.ac.kr
2Department of Surgery, Red Cross Hospital, Seoul, Korea.
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Abstract

PURPOSE
Surgical removal for a mass in the pre-sacral space or mid rectum through a posterior approach is not frequent. We would like to present the technique of trans-sacral local resection as a posterior approach. We analyzed the follow up of patients who underwent surgery using the proposed technique.
METHODS
A total of 21 patients who had undergone a trans-sacral local resection with lower sacrectomy between January 1997 and December 2006 were enrolled in this study. The diagnoses were large epidermal cyst, gastrointestinal stromal tumor, high grade adenoma, and early cancers in the mid rectum. We analyzed the surgical complications and disease recurrences. The mean follow up for tumors of the rectum was 53+/-35 mo.
RESULTS
Epidural anesthesia was appropriate for all whole procedures. Among the 21 cases, there was one case of a rectocutaneous fistula as a postoperative complication (4.9%). In one case among the submucosal cancers, there was a systemic metastasis at 24 mo without local recurrence.
CONCLUSION
In our experience, a trans-sacral resection with a lower sacrectomy is a good option and provides a wide and direct surgical exposure for the removal of a pre-sacral or a mid-rectal mass. Good bowel preparation is mandatory.

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