Transsacrococcygeal approach for the management of presacral developmental cysts: experience of 43 cases

Abstract

Objective To summarize the clinical features of presacral developmental cysts and investigate the therapeutic effect of transsacrococcygeal approach. Methods Clinical data of 43 patients with presacral developmental cysts underwent transsacrococcygeal approach from August 2007 to August 2016 was retrospectively analyzed. Results In this group, four male and 39 female patients were included. The clinical presentations were nonspecific and sixteen patients were misdiagnosed before the correct diagnosis was made. All patients were treated with tanssacrococcygeal approach. The operative duration was (125±43) min and the blood loss of each operative approach was (157±56) ml. Coccygectomy was performed in 32 patients and partial sacral resection was performed in four patients. The surgical incision infection occurred in two patients (4.6%). Postoperative pathological findings: fifteen patients had tailgut cysts, nine patients had epidermoid cysts, fourteen patients had teratomas, four patients had dermoid cysts and one patient had malignant teratocarcinoma. The patients were followed up for 6~74 months (mean, 45 months) and the tumor relapsed in one patient (2.3%). Conclusions The clinical presentations were nonspecific and patients with presacral developmental cysts were easily misdiagnosed at first visit. Transsacrococcygeal approach can be used to manage majority of presacral developmental cysts with less blood loss and lower complication rate. Key words: Presacral developmental cysts; Misdiagnosis; Transsacrococcygeal approach