3D reconstruction of presacral tumours prior to Kraske procedure—a video vignette

Abstract

Presacral tumors are rare neoplasms with an incidence of 1/63,000 [1] and present with a wide variety of histological types. The malignancy rate, however, tends to be about 33% [2]. Surgery is usually indicated even in benign lesions, but is greatly dependent on the risk of malignancy and malignant degeneration[3]. A posterior approach is indicated in benign tumours, located below the S3 vertebra and without the involvement of adjacent organs. Benefits of the posterior approach include lower morbidity and faster recovery whereas the major disadvantages of this technique include less control over the pelvic vessels and the possibility of injury to the pelvic nerves, both of which can be minimized with appropriate case selection. Given the wide variety of lesions, complex locations, and different surgical approaches available, careful surgical planning is indispensable.