World Journal of Laparoscopic Surgery

Register      Login

VOLUME 16 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Paradigm Shift in the Management of Benign Pelvic Neurogenic Tumors: A Single Institution Experience

Subbiah Shanmugam, RR Pravenkumar

Keywords : Laparoscopic excision, Neurofibroma, Pelvic malignancy, Pelvic neurogenic tumors, Presacral neurofibroma, Presacral schwannoma, Presacral tumors, Schwannoma

Citation Information : Shanmugam S, Pravenkumar R. Paradigm Shift in the Management of Benign Pelvic Neurogenic Tumors: A Single Institution Experience. World J Lap Surg 2023; 16 (3):145-148.

DOI: 10.5005/jp-journals-10033-1595

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background and objective: Benign neurogenic tumors are relatively rare in the pelvis and are mostly benign. These tumors are in proximity to multiple structures given the bony confines of the pelvis and its complex anatomy, thus making it a surgical challenge. From the conventional open surgical approach, we have moved on to laparoscopic excision. We sought to analyze the outcomes of surgical excision of such tumors. Materials and methods: Data of patients who underwent excision of benign pelvic neurogenic tumors either by open or laparoscopic surgery at our institution between 2016 and 2022 were reviewed and analyzed. Results: A total of seven patients underwent surgery, four by laparotomy and three by laparoscopy. Six patients had tumors located in the presacral space, and one was found in the lateral wall of the pelvis. The mean operative time was less in laparoscopy (140 vs 125 minutes), with a mean blood loss of 100 (90–110) mL. The mean duration of hospital stay was less in laparoscopy (7 vs 4 days). Three patients of open surgery had postoperative complications whereas no complications occurred after laparoscopy. Postoperative pathological examinations showed three schwannomas and four neurofibromas. No patient experienced local recurrence during a mean follow-up period of 30 months. Conclusion: Laparoscopy is a feasible alternative approach to open surgery for resection of pelvic neurogenic tumors with the advantages of better visualization and preservation of pelvic neurovascular structures, minimal operative morbidity, lesser postoperative pain, and shorter hospital stay.


HTML PDF Share
  1. Eric J. Dozois Shackelfords surgery of the alimentary tract. Retrorectal tumors: Elsevier: 8th edition, Vol 2, Chapter 174. pp. 2103–2116.
  2. Woodfield JC, Chalmers AG, Phillips N, et al. Algorithms for the surgical management of retro rectal tumours. Br J Surg 2008;95(2):214–221. DOI: 10.1002/bjs.5931.
  3. Imboden S, Al-Fana A, Kuhn A, et al. Pandora's box and retrorectal tumors in laparoscopy: A case report and review of the literature. Int J Surg Case Rep 2014;5(10):706–709. DOI: 10.1016/j.ijscr.2014. 08.012.
  4. Hernández Casanovas MP, Martinez MC, Bollo J, et al. Laparoscopic approach for retrorectal tumors – Results of a series of 11 cases. Ann Laparosc Endosc Surg 2017;2(8):126. DOI: 10.21037/ales.2017.07.10.
  5. Nedelcu M, Andreica A, Skalli E, et al. Laparoscopic approach for retrorectal tumors. Surg Endosc 2013;27:4177–4183. DOI: 10.1007/s0046401330171.
  6. Zhou J, Zhao B, Qiu H, et al. Laparoscopic resection of large retrorectal developmental cysts in adults: Singlecentre experiences of 20 cases. J Min Access Surg 2020;16(2):152–159. DOI: 10.4103/jmas.JMAS_214_18.
  7. Deng C, Wang P, Liu Y, et al. Laparoscopic resection of pelvic schwannomas: A 9-year experience at a single center. World Neurosurg X 2022;17:100150. DOI: 10.1016/j.wnsx.2022.100150.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.