PRESACRAL TUMOR - A REVIEW OF 45 CASES

Forty-five patients with primary presacral tumors underwent their trea tment at Division of Colon Rectal Surgery, Chang Gung Memorial Hospita l, from 1978 to 1992. These 45 patients, 20 male and 25 female, ranged from 15 to 76 years of age (mean, 41.1 years). Congenital tumors (47 per cent) were the most frequent histologic type, followed by miscella neous tumors (36 per cent). Forty-eight per cent of patients had malig nant tumors. All benign congenital cysts were in females. These tumors presented a variety of symptoms and signs. Diagnosis could be made by digital examination in 43 (96 per cent) of the patients. Computed tom ographic scan was the most important diagnostic tool in determining th e extent and degree of tumor invasion. The positive rate was 100 per c ent in 21 patients. As for operative methods, abdominal approach was s elected in 24 patients, transacral in 13 patients, abdominal/sacral co mbined in 6 patients, and biopsy only in two patients. Postoperative c omplications occurred in 16 patients (36 per cent), but there were no operative deaths. Of the tumors that underwent resection, 23 had total resection (18 benign and 5 malignant) and 22 incomplete (5 benign and 17 malignant). Benign tumors had a good chance with resection of the lesion (P < 0.05). For patients with malignant tumors, the Ei-year sur vival rate was 40.7 per cent. Whenever possible, total resection could offer better results for presacral tumor, whether the lesions were be nign or malignant.