Clinical effect of transsacrococcygeal approach for the treatment of presacral cyst
ZHANG Lin,TUERHONG Maimaitiming,ZHAO Li-zhong
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.
