| 摘要: |
| 目的:分析27例经骶尾入路手术治疗骶前囊肿的临床特点及诊治经验。方法:回顾性分析2018年1月—2018年12月天津市人民医院肛肠病诊疗中心及2019年7月—2021年1月新疆和田地区人民医院肛肠外科收治的27例成人骶前囊肿的临床资料，探讨成人骶前囊肿的诊断和治疗经验。结果:本组27例患者中男性4例，女性23例；女性多于男性，患者年龄27～65(平均32.8)岁，病程4 d～9年。全部病例均经骶尾入路切除行手术治疗，手术时间40～260(平均97.3)min；术中出血30～300(平均86.4)mL，均无骶前静脉丛损伤出血及术中输血。其中9例行尾骨切除；18例行骶尾部横切口，9例纵切口；27例均完整切除囊肿；术中均无直肠损伤及神经损伤；术后24例伤口一期愈合，3例分别于术后3～4周愈合。结合术前影像及术中探查，囊肿直径3～11(平均8.13)cm。术后病理均为良性，表皮样囊肿24例(其中表皮样囊肿伴感染7例)，皮样囊肿3例。术后随访48个月，27例均无复发。结论:骶前囊肿因其临床表现不典型，常被误诊，彻底切除病灶囊壁可以预防复发和可能发生的恶变，低位骶前囊肿的手术路径可选择经骶尾入路。 |
| 关键词: 骶前囊肿 经骶尾入路 外科手术 |
| DOI：10.3969/j.issn.1007-6948.2025.05.005 |
| 投稿时间：2025-04-20 |
| 基金项目:天津市中西医结合重点专科项目(中西医结合肛肠外科)；国家中医药管理局中西医协同“旗舰”科室 |
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| Clinical effect of transsacrococcygeal approach for the treatment of presacral cyst |
| ZHANG Lin,TUERHONG Maimaitiming,ZHAO Li-zhong |
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| Abstract: |
| Objective The clinical characteristics, diagnosis and treatment experience of 27 cases of presacral cyst treated by transsacrococcygeal approach were retrospectively analyzed. Methods The clinical data of 27 cases of adult presacral cysts in the Department of Colorectal Surgery of Tianjin Union Medical Center from January 2018 to December 2018 and Hetian District People′s Hospital from July 2019 to January 2021 were analyzed retrospectively. To explore the diagnosis and treatment of adult presacral cysts. Results In this group, there were 4 males and 23 females.The median age at diagnosis was 27-65(mean 32.8) years, with a course of disease ranging from 4 days to 9 years. All patients underwent surgical treatment, and were resected through the transsacrococcygeal approach. The operation time was 40-260(mean 97.3)min. Intraoperative blood loss was 30-300 (mean 86.4) mL, no presacral venous plexus injury bleeding, no intraoperative blood transfusion. Coccygectomy was performed in 9 cases;There were 18 transverse incisions, 9 longitudinal incisions. The cysts were completely excised in all 27 cases.There were no intraoperative rectal injury or nerve injury.The wounds of the 24 patients healed in the first stage, and 3 patients healed at 3-4 weeks after surgery. Combined with preoperative imaging and intraoperative observation, cyst diameter of 3-11 (mean 8.13) cm. The postoperative pathology was all benign, with24 cases of epidermoid cyst (including 7 cases of epidermoid cyst with infection) and 3 cases of dermoid cyst. After postoperative follow-up of 48 months, 27 had no recurrence. Conclusion Pressacral cyst because of its atypical clinical manifestations, it is often misdiagnosed. Thorough resection of the cystic wall of the lesion can prevent recurrence and possible malignant changes, and the surgical path of low presacral cyst can be selected through the transsacrococcygeal approach. |
| Key words: Presacral cyst transsacrococcygeal approach surgical operation |
