Neurological outcome following resection of benign presacral neurogenic tumors using a nerve-sparing technique

Marie Noelle Hébert-Blouin, Patrick S. Sullivan, Amit Merchea, Daniel Léonard, Robert J. Spinner, Eric J. Dozois

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Benign presacral nerve sheath tumors represent up to 10% of all presacral tumors. Limited data exist regarding the impact of the surgical technique on neurological outcomes following resection. Objective: The aim of this study was to test our hypothesis that a nerve-sparing resection technique results in the improvement of preoperative neurological dysfunction and minimal postoperative neurological morbidity. DESIGN: This study is a case series of all patients with benign neurogenic presacral tumors operated on by the same 2 surgeons between 2004 and 2010 at our institution. SETTINGS: This study was performed at a tertiary care center. PATIENTS: Adult patients with benign presacral neurogenic tumors who underwent a nerve-sparing resection were included. MAIN OUTCOME MEASURES: Postoperative urogenital, anorectal, and lower-extremity neurological functions were analyzed. Results: Seventeen patients were identified with a mean age of 40 years; 14 were women. Preoperatively, 13 patients had symptoms from neurological dysfunction or presumed mass effect of the tumor. The mean tumor size was 7.4 cm. The pathology was a schwannoma in 12 patients and neurofibroma in 5 patients. Mortality was nil, and 30-day morbidity was noted in 3 patients (hemorrhage, ileus, acute respiratory distress syndrome, deep vein thrombosis, and transient foot drop). Mean follow-up was 36 months. Of the 13 symptomatic patients, 7 achieved complete resolution of symptoms and 5 had improved, but persistent symptoms. None of the 4 asymptomatic patients developed postoperative neurological dysfunction. LIMITATIONS: Small sample size was a limitation of this study. Conclusions: With the use of a nerve-sparing technique, function-preserving resection can be safely completed with an overall improvement in symptoms.

Original languageEnglish (US)
Pages (from-to)1185-1193
Number of pages9
JournalDiseases of the colon and rectum
Volume56
Issue number10
DOIs
StatePublished - Oct 1 2013

Keywords

  • Nerve sheath tumor
  • Neurogenic tumor
  • Presacral tumor

ASJC Scopus subject areas

  • Gastroenterology

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