[Laparoscopic resection of neurogenic presacral tumors].

Abstract

Laparoscopic approach is common in pelvic tumor surgery. Several small samples of patients after laparoscopic resection of presacral neurogenic tumors were described. Safety and advantages of this intervention are interesting.

Objective: To analyze clinical outcomes of laparoscopic resection of presacral neurogenic tumors.

Material and methods: Eleven patients including 2 children aged 11 and 17 years underwent laparoscopic tumor resection between 2021 and 2024. We estimated tumor size and localization, surgery time, blood loss, complications, postoperative hospital-stay, histological diagnosis and continued growth or recurrence in the follow-up period. The median follow-up was 19.2 (3-36) months.

Results: Tumor size ranged from 4 to 10 cm, mean surgery time - 153.6 min, blood loss - 356.4 ml. Postoperative complications developed in 7 patients, including acute urinary retention, neuropathic pain syndrome, hematomas and dynamic intestinal obstruction. Total resection was achieved in 8 (72.7%) patients, subtotal resection - 2 (18.2%), partial resection - 1 (9.1%) case. Tumors were predominantly neurogenic: 6 (54.5%) - sacral nerve schwannomas, 1 (9%) - NF1-related schwannomatosis, 1 (9%) - meningioma, 1 (9%) - ganglioneuroma, 1 (9%) - fibromyxoid sarcoma, 1 (9%) - solitary fibrous tumor. There were no recurrences, continued growth or recurrence of preoperative symptoms in the follow-up period.

Conclusion: Laparoscopic resection of presacral neurogenic tumors is an effective surgical technique with good visualization of surgical field and possible gross total resection.