Sacrectomía en bloque para tumores gigantes del sacro preservando las raíces de S1. Reporte de nueva técnica quirúrgica y resultado funcional

Abstract

Sacral primary tumors are rare lesiones that are characterized to be locally expansive and agressive, often present with osteolysis and with great chances to recurr at short-run term after a first surgical reseccion. There are multiple described options for management and treatment, including radiotherapy and chemotherapy for the relief of pain and surgical reseccion in order to provide long-term control over tumor growth or definitive cure. Given the nature of such lesions, en bloc sacrectomy is the surgical technique that involves less local recurrence, however, given the extensión of sacral tumors at diagnosis, usually surgical resection means sacrificing nerve roots, directly impacting over long-term morbidity. Secondary major complicactions most frequently observed include impaired ambulation, genitourinary, gastrointestinal and sexual function. The aim of this article is to describe three cases where en bloc sacrectomy were performed for management of primary sacral tumors (two gigant cell tumors and one hemangioma) with preservation of nerve roots and their outcome up tu 36 months of postoperative follow-up.