Analysis of the causes of long-standing pelvic anterior sacral space infection and discussion of management techniques.
10.3760/cma.j.cn112152-20210217-00136
- Author:
Gang Cheng WANG
1
;
Hong Le LI
2
;
Yang LIU
2
;
Xiang Hao GU
3
;
Rui Xia LIU
3
;
Rui FENG
3
;
You Cai WANG
2
;
Ying Jun LIU
2
;
Guo Qiang ZHANG
2
;
Zhi ZHANG
2
;
Hong Li WANG
2
;
Fang WANG
2
;
Yan ZHANG
2
Author Information
1. Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450003, China Department of Gneneral Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China.
2. Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450003, China.
3. Henan Institute of Medical Information, Zhengzhou 450018, China.
- Publication Type:Journal Article
- Keywords:
Anastomotic leak;
Anterior sacral infection;
Anterior sacral transverse arc incision;
Radiotherapy;
Rectal neoplasms
- MeSH:
Humans;
Reinfection;
Rectum/surgery*;
Rectal Neoplasms/surgery*;
Drainage;
Anal Canal/surgery*;
Pelvic Infection
- From:
Chinese Journal of Oncology
2023;45(3):273-278
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the causes and management of long-term persistent pelvic presacral space infection. Methods: Clinical data of 10 patients with persistent presacral infection admitted to the Cancer Hospital of Zhengzhou University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral infection according to the patients' initial surgical procedures. Results: Among the 10 patients, there were 2 cases of presacral recurrent infection due to rectal leak after radiotherapy for cervical cancer, 3 cases of presacral recurrent infection due to rectal leak after radiotherapy for rectal cancer Dixons, and 5 cases of presacral recurrent infection of sinus tract after adjuvant radiotherapy for rectal cancer Miles. Of the 5 patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete debridement of the presacral infection using an anterior transverse sacral incision with a large tipped omentum filling the presacral space; 1 had continuous drainage of the anal canal and complete debridement of the presacral infection using an anterior transverse sacral incision. 5 post-Miles patients all had debridement of the presacral infection using an anterior transverse sacral incision combined with an abdominal incision. The nine patients with healed presacral infection recovered from surgery in 26 to 210 days, with a median time of 55 days. Conclusions: Anterior sacral infections in patients with leaky gut are caused by residual bowel secretion of intestinal fluid into the anterior sacral space, and in post-Miles patients by residual anterior sacral foreign bodies. An anterior sacral caudal transverse arc incision combined with an abdominal incision is an effective surgical approach for complete debridement of anterior sacral recalcitrant infections.
