TITLE:
A Single Center Retrospective Analysis of Kraske’s Transsacral Approach: A Review
AUTHORS:
Cédric Bouts, Kurt Van der Speeten
KEYWORDS:
Presacral Tumor, Magnetic Resonance Imaging, Transsacral Approach, Kraske
JOURNAL NAME:
Surgical Science,
Vol.5 No.10,
October
22,
2014
ABSTRACT: Aim: Presacral lesions are
uncommon and represent a diagnostic and surgical challenge. The aim of this
study is to present our experience with Kraske’s transsacral resection and to
review current literature. Methods: Seven patients who had a transsacral
resection between 2001 and 2013were
reviewed retrospectively. Results: Two men and five women with a mean age of 39
(range 17- 60) years were
diagnosed with a presacral lesion. The clinical presentation was nonspecific;
pain was the most common symptom. All lesions were palpable on digital rectal
examination. Magnetic resonance imaging (MRI) was necessary to assess the
tumor’s extent, biological behavior and relationship to adjacent structures.
MRI predicted malignancy with 100% accuracy. All lesions were located below S3
and underwent a transsacral resection. Pathological examination revealed four
tailgut cysts, two epidermoid cysts and one chordoma. Postoperative
complications included wound infections (two cases) and spasms of the gluteus
muscle (one case). We reported no recurrence or mortality. Conclusion: Clinical
awareness, the use of MRI in the routine work-up and avoidance of an incisional
biopsy result in a good outcome after surgical resection of presacral lesions.
Kraske’s approach can be used for presacral lesions below S3, resulting in low
morbidity, no recurrence and no mortality.