Diagnosis And Treatment Of Primary Presacral Tumors

Presacral tumors are a rare problem, which are defined by their histologic components and retrorectal location, lying anterior to the sacrum and posterior to the tectum. The first classification of presacral tumors was described in 1949 by Lovelady and Dockerty. This classification included congenital, neurogenic, osseous and miscellaneous tumors. Subsequent series have demonstrated that congenital tumors are most common type of presacral tumors, accounting for over 60 percent of cases. Developmental cysts are most common congenital tumors and include epidermoid cysts, dermoid cysts, and enteric cysts. There are two types of enteric cysts: tailgut cysts(so-called retrorectal cyst and cyst-hamartomas or mucin-secreting cysts ) and cystic rectal duplication. Neurenteric cysts have also been reported. The histologic picture of these tumors is confusing, diagnostic and therapeutic options are many, and surgens have had little experience with them. In an effort to place the different pathologic entities, the appropriate diagnostic choices and therapeutic results, we review the recent experience with retrorectal tumors at the first hospital affiliated to Jilin University. The clinic date of 16 patients with presacral tumors who were performed between 2000 to 2008 in department of common surgery of the first hospital affiliated to Jilin University was analyzed. This paper aims to explore the current understanding of presacral tumors in our hospital the patient's diagnosis, treatment status, sum up experience, so as to enhance the diagnosis and treatment of presacral tumors. The results showed that: Rectal examination proved to be the most reliable physical test in this study. B-ultrasonography is a super-imaging diagnosis of presacral tumors, and non-invasive examination such as CT, MRI also play an important role in diagnosis of presacral tumors. The main therapy was surgical resection. The opportunity to resect and eliminate the disease depends on the size and the location of the tumor. developmental cysts. Three approaches to presacral tumors were undertaken: posterior, anterior (abdominal), combined,or transvaginal excision. The posterior approach alone was preferred for small benign tumors or infected cysts in the lower part (below S4) of the presacral space. Conclusions: Presacral tumors should be strengthened for early diagnosis and early treatment.