Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Int Orthop. 2012 Mar;36(3):607-12. doi: 10.1007/s00264-011-1381-9. Epub 2011 Oct 29.
The study was carried out to report the results of wide resection in sacral chordoma using a posterior approach and gauze packing technique.
The study was carried out between 1990 and 2002; there were 21 patients who underwent the operation. Fourteen patients were male and seven were female. Their ages ranged between 29 and 75 years. Most of the patients presented with sacral mass, pain and neurological deficit. Total sacrectomy and bone reconstruction were carried out in 12 patients. Subtotal sacrectomy was carried out in the remaining nine patients. All patients were followed up for at least seven years.
All survived after the operation. Operative time ranged between five and ten hours. All patients needed blood transfusion which ranged between four and 11 units. After the operation, all patients had a certain degree of bowel and bladder dysfunction. Five patients had local complications including infection in three patients with wound disruption and two patients with a seroma. During the follow-up, three patients (14%) had tumour recurrence and one of the patients expired. The remaining 18 patients were still tumour-free at the seven-year follow-up.
Wide resection via the posterior approach and gauze packing technique could be used for management of sacral chordoma with acceptable results.
本研究旨在报告采用后路和纱布填塞技术进行广泛切除骶骨脊索瘤的结果。
本研究于 1990 年至 2002 年进行，共有 21 例患者接受了手术。14 例为男性，7 例为女性。年龄在 29 岁至 75 岁之间。大多数患者表现为骶骨肿块、疼痛和神经功能缺损。12 例患者行全骶骨切除术和骨重建术，9 例患者行次全骶骨切除术。所有患者均至少随访 7 年。
所有患者术后均存活。手术时间为 5 至 10 小时。所有患者均需要输血，输血量为 4 至 11 单位。术后，所有患者均有一定程度的肠和膀胱功能障碍。5 例患者发生局部并发症，包括 3 例伤口裂开伴感染和 2 例血清肿。随访期间，3 例（14%）患者肿瘤复发，其中 1 例患者死亡。其余 18 例患者在 7 年随访时仍无肿瘤。
后路和纱布填塞技术的广泛切除可用于治疗骶骨脊索瘤，结果可接受。
