CORRELATION BETWEEN TYPES OF SACRAL TUMOR RESECTION, HISTOLOGY, AND LOCAL RECURRENCEObjectives: Sacrectomies are usually the treatment of choice for sacral tumors. Depending on the location, size, and histological type, different resection options can be used, with varying levels of morbidity and mortality inherent to the procedure. In Brazil, there is limited literature on complications resulting from this treatment. The purpose of this article is to correlate such surgeries with the outcomes of patients undergoing them, such as local recurrence, infection, neurological deficit, and life expectancy.
Methods: Retrospective cohort study with a sample of 16 patients with sacral tumors undergoing sacral resection from 2015 to 2023. Some variables were studied, such as histological type of the tumor, surgical modality performed, reconstructions with sacropelvic instrumentation, tumor margins, type of flap for closure, local tumor recurrence, and follow-up. Data were recorded preoperatively and at the last follow-up visit. Patients with a follow-up of less than 6 months and patients with incomplete data in the medical records were excluded from the study.
Results: Sixteen patients were selected; the ratio was 11 men (68.8%) and five women (31.2%); the mean age was 49.3 years, ranging from 24 to 76 years. The diagnosis involved benign tumors in 6 patients (37.5%) and malignant tumors in 10 of them (62.5%). Various sacropelvic reconstruction modalities were performed on eight patients (50%) when there was involvement of more than 50% of the sacroiliac joint. The average follow-up time for this patient sample was 39.5 months, with the shortest follow-up time being 6 months and the longest being 70 months. A total of 25 complications were observed in the sample, present in 13 (81.2%) patients, with 8 (61.5%) of them having two complications. The main complications were deficits (69.1%), followed by infection (61.5%), and other causes (38.4%), such as non-union and posterior perineal hernia.
Conclusion: Sacrectomy is a procedure with a high rate of complications, mainly neurological deficits - inherent to the nature of the surgery - and surgical site infection. Patient disease-free local follow-up is directly linked to sacrectomy ‘en bloc’ with clear margins. More multicenter studies with longer follow-up are needed for confirmation. Level of Evidence IV; Case Series.
Keywords:
Tumor; Sacrum; Spinal Neoplasms
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