ABSTRACT

Aim:To identify sacrococcygeal approach as one of the best approach for complete excision of presacral tumors with minimum morbidity and mortality.

Method:In this study nine cases of presacral tumors are reported, seven females and two males, with mean age of (34.1 years), ranging from 17 to 58 years old, most of the cases are referred from other centers as cases of complicated sacrococcygeal pilonidal sinuses and retrorectal masses, five patients out of the seven had been operated before for the same complain and presented to us for recurrence of their symptoms after incomplete excision or misdiagnosed at the beginning ,they were admitted in Slemani Surgical Teaching Hospital and Soma Private Hospital with in a period of five years, after proper history and physical examination, investigations were requested and finally were diagnosed with histopathological result, These data were taken from the hospital’s medical records and direct interview with the patients, consent was taken from all the patients regarding publishing their records in this series.

Result: sacrococcygeal approach resulted in complete resection of presacral tumors in all nine cases included in the study, with smooth post operative period and no recurrence recorded in the follow up period which was two years, pathological findings: fivemature cystic teratoma, one enterogenous cyst, one chondroma, and two tailgut cysts. No perioperative death.

Conclusion:the main treatment for presacral tumors is surgical, bowel preparation is necessary because sometimes the tumor invaded the rectum and the procedure may end with colostomy, in our study we approached all the cases through sacrococcygeal approach, complete excision of the tumor is necessary in order to prevent recurrence, daily dressing of the wound is mandatory to avoid secondary bacterial infection.

Keywords: Presacral tumors, sacrococcygeal approach, enterogenous