TY - JOUR
T1 - Neurological outcome following resection of benign presacral neurogenic tumors using a nerve-sparing technique
AU - Hébert-Blouin, Marie Noelle
AU - Sullivan, Patrick S.
AU - Merchea, Amit
AU - Léonard, Daniel
AU - Spinner, Robert J.
AU - Dozois, Eric J.
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - Nerve sheath tumor
KW - Neurogenic tumor
KW - Presacral tumor
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U2 - 10.1097/DCR.0b013e31829e4e4f
DO - 10.1097/DCR.0b013e31829e4e4f
M3 - Article
C2 - 24022536
AN - SCOPUS:84884476782
SN - 0012-3706
VL - 56
SP - 1185
EP - 1193
JO - Diseases of the colon and rectum
JF - Diseases of the colon and rectum
IS - 10
ER -