An analysis of clinical effects of surgical resection of sacral tumors adjuvant with Cryo-Hit
PENG Zhi-heng
WANG Ji-xing
JIANG Jian-ming
QU Dong-bin
LU Kai-wu
JIANG Hui
WANG Hai-ming
CHEN Jian-ting
Abstract：Objective To evaluate the clinical effects of surgical resection of sacral tumors adjuvant with Cryo-Hit. Methods From January 2007 to December 2012, the clinical data of 15 consecutive patients with sacral tumors who were treated with resection adjuvant with Cryo-Hit and were followed up were retrospectively analyzed. There were 9 males and 6 females, whose average age was 51.3 years old ( range;38-78 years ). There were 12 cases of chordomas, 1 case of giant cell tumor of bone, 1 case of ifbromatosis in the sacroiliac region and 1 case of metastatic tumor in the sacrum, which were conifrmed by the postoperative pathology. Tumors were found in S2 ( n=8 ) and below S3 ( n=6 ). Recurrence was noticed in the buttock in 1 case. The course ranged from 2 months to 9 years. Sacrococcygeal pain occurred in 90%of all the patients, sciatica in 6 patients, and bladder and ( or ) rectal dysfunction in varying degrees in 12 patients. All the patients received surgical resection of sacral tumors adjuvant with Cryo-Hit. A combination of anterior and posterior approaches was adopted in 14 patients. In the anterior approach isolation and exposure of tumors was performed under laparoscope, and in the posterior approach Cryo-Hit was used to freeze and completely resect tumors. Palliative posterior surgery was performed alone on 1 patient with metastatic tumor in the sacrum, due to the poor body condition. Results The mean operation time was 315 min, and the mean blood loss was 1065 ml. The mean drainage lfow was 635 ml, and the mean postoperative hospital stay was 19.2 days. All the patients were followed up for an average period of 26 months ( range;5-48 months ). There were 14 patients alive, and the total survival rate was 93.3%. The bilateral nerve roots in S2 and above were successfully spared in all the patients, and no motor or sensory disturbances of lower limbs were noticed. The Visual Analogue Scale ( VAS ) scores were ( 6.80±1.52 ) points and ( 2.33±0.90 ) points preoperatively and at discharge, and the differences were statistically significant ( P<0.001 ). No normal tissue necrosis caused by freeze was found during the operation. No serious complications including fractures, deep wound infections, fever, neurological deifcits or cerebrospinal lfuid leakage were noticed at discharge. Poor wound healing occurred in 5 patients, and bladder and rectal dysfunction became more serious than that before the operation in 1 patient. Among the 15 patients, 2 patients had local recurrence and the recurrence rate was 13.3%. Conclusions Surgical resection of sacral tumors adjuvant with Cryo-Hit is a simple, feasible and safe technique, with the advantages of complete resection, less blood loss and rapid palliation of the pain. The intraoperative instant effects are obvious, and the recent curative results are satisfactory.
Keywords：Spinal neoplasmsSacrumNeoadjuvant therapyReconstructive surgical proceduresArgon-helium knife
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 351-355 )