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Onaitis, M., Ludwig, K., Perez-Tamayo, A., Gottfried, M., Russell, L., Shadduck, P., et al. (2006) The Kraske Procedure: A Critical Analysis of a Surgical Approach for Mid-Rectal Lesions. Journal of Surgical Oncology, 94, 194-202. http://dx.doi.org/10.1002/jso.20591

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• TITLE: A Single Center Retrospective Analysis of Kraske’s Transsacral Approach: A Review

  AUTHORS: Cédric Bouts, Kurt Van der Speeten

  KEYWORDS: Presacral Tumor, Magnetic Resonance Imaging, Transsacral Approach, Kraske

  JOURNAL NAME: Surgical Science, Vol.5 No.10, October 22, 2014

  ABSTRACT: Aim: Presacral lesions are uncommon and represent a diagnostic and surgical challenge. The aim of this study is to present our experience with Kraske’s transsacral resection and to review current literature. Methods: Seven patients who had a transsacral resection between 2001 and 2013were reviewed retrospectively. Results: Two men and five women with a mean age of 39 (range 17- 60) years were diagnosed with a presacral lesion. The clinical presentation was nonspecific; pain was the most common symptom. All lesions were palpable on digital rectal examination. Magnetic resonance imaging (MRI) was necessary to assess the tumor’s extent, biological behavior and relationship to adjacent structures. MRI predicted malignancy with 100% accuracy. All lesions were located below S3 and underwent a transsacral resection. Pathological examination revealed four tailgut cysts, two epidermoid cysts and one chordoma. Postoperative complications included wound infections (two cases) and spasms of the gluteus muscle (one case). We reported no recurrence or mortality. Conclusion: Clinical awareness, the use of MRI in the routine work-up and avoidance of an incisional biopsy result in a good outcome after surgical resection of presacral lesions. Kraske’s approach can be used for presacral lesions below S3, resulting in low morbidity, no recurrence and no mortality.