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Techniques in Coloproctology
Published in: Techniques in Coloproctology 6/2016

01-06-2016 | Technical Note

Posterior high sacral segmental disconnection prior to anterior en bloc exenteration for recurrent rectal cancer

Authors: K. G. M. Brown, M. J. Solomon, K. K. S. Austin, P. J. Lee, P. Stalley

Published in: Techniques in Coloproctology | Issue 6/2016

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Abstract

This article describes a novel technique for en bloc resection of locally recurrent rectal cancer that invades the high sacral bone (above S3). The involved segment of the sacrum is mobilised with osteotomes during an initial posterior approach before an anterior abdominal phase where the segment of sacral bone is delivered with the specimen. This allows en bloc resection of the involved sacrum while preserving uninvolved distal and contralateral sacral bone and nerve roots. The goal is to obtain a clear bony margin and offer a chance of cure while improving functional outcomes by maintaining pelvic stability and minimising neurological deficit.
Literature
1.
Bhangu A, Ali SM, Darzi A, Brown G, Tekkis P (2012) Meta-analysis of survival based on resection margin status following surgery for recurrent rectal cancer. Colorectal Dis 14:1457–1466CrossRefPubMed
2.
Harji DP, Griffiths B, McArthur DR, Sagar PM (2013) Surgery for recurrent rectal cancer: higher and wider? Colorectal Dis 15:139–145CrossRefPubMed
3.
4.
Milne T, Solomon MJ, Lee P, Young JM, Stalley P, Harrison JD (2013) Assessing the impact of a sacral resection on morbidity and survival after extended radical surgery for locally recurrent rectal cancer. Ann Surg 258:1007–1013CrossRefPubMed
5.
Colibaseanu DT, Dozois EJ, Mathis KL et al (2014) Extended sacropelvic resection for locally recurrent rectal cancer: can it be done safely and with good oncologic outcomes? Dis Colon Rectum 57:47–55CrossRefPubMed
6.
Austin KK, Solomon MJ (2009) Pelvic exenteration with en bloc iliac vessel resection for lateral pelvic wall involvement. Dis Colon Rectum 52:1223–1233CrossRefPubMed
7.
Mirnezami AH, Sagar PM, Kavanagh D, Witherspoon P, Lee P, Winter D (2010) Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum 53:1248–1257CrossRefPubMed
8.
Fourney DR, Rhines LD, Hentschel SJ et al (2005) En bloc resection of primary sacral tumors: classification of surgical approaches and outcome. J Neursurg Spine 3:111–122CrossRef
9.
Solomon MJ, Tan KK, Bromilow RG, Al-mozany N, Lee PJ (2014) Sacrectomy via the abdominal approach during pelvic exenteration. Dis Colon Rectum 57:272–277CrossRefPubMed
10.
Li D, Guo W, Tang X et al (2014) Preservation of the contralateral sacral nerves during hemisacrectomy for sacral malignancies. Eur Spine J 23:1933–1939CrossRefPubMed
11.
Evans MD, Harji DP, Sagar PM et al (2013) Partial anterior sacrectomy with nerve preservation to treat locally advanced rectal cancer. Colorectal Dis 15:e336–e339CrossRefPubMed
12.
Shaikh I, Holloway I, Aston W et al (2015) High subcortical sacrectomy [HiSS]: a novel approach to facilitate complete resection of locally advanced and recurrent rectal cancer with high [S1–S2] sacral extension. Colorectal Dis. doi:10.​1111/​codi.​13226
Metadata
Title
Posterior high sacral segmental disconnection prior to anterior en bloc exenteration for recurrent rectal cancer
Authors
K. G. M. Brown
M. J. Solomon
K. K. S. Austin
P. J. Lee
P. Stalley
Publication date
01-06-2016
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 6/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-016-1456-0

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