Surgical Management of Sacrococcygeal Region Giant Tumors by Use of Balloon Occlusion Abdominal Aorta

Turk Neurosurg. 2016;26(6):904-911. doi: 10.5137/1019-5149.JTN.13606-14.1.

Abstract

Aim: Sacrococcygeal region giant tumors are a challenge for neurosurgeons. The purpose of this paper was to retrospectively analyze the clinical records of sacrococcygeal region giant tumors treated surgically by balloon occlusion of the abdominal aorta.

Material and methods: A total of 130 patients of sacral region tumors underwent surgery in our department from February 2009 to February 2013. Among these patients, 35 giant tumors were treated by balloon catheter occlusion of the abdominal aorta and electrophysiological monitoring. Thirty patients returned for follow-up evaluations and their clinical and imaging records were analyzed.

Results: Thirty patients underwent surgery via a posterior approach; these cases included 21 chordomas, 5 schwannomas, and 4 giant cell tumors of bone. Wide resections were performed in 26 patients (86.7%) and margin resections were performed in 4 (13.3%) patients. Most patients' symptoms were relieved through surgery and only nine patients (30%) experienced recurrence of the tumors during follow-up.

Conclusion: Sacrococcygeal region giant tumors are still difficult to treat, especially for malignant tumors. Balloon catheter occlusions of the lower abdominal aorta can notably decreased intraoperative hemorrhage, shorten operation time, and decrease postoperative complications. This method is a good choice for neurosurgeons to manage these giant tumors in the sacral region.

MeSH terms

  • Adult
  • Aged
  • Aorta, Abdominal / surgery*
  • Balloon Occlusion / methods*
  • Blood Loss, Surgical / prevention & control
  • Female
  • Giant Cell Tumors / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Sacrococcygeal Region / surgery*