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En-bloc excision of sacral squamous cell carcinoma with immediate reconstruction

  • Technical Note
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Sacral squamous cell carcinoma is an uncommon condition that may arise in scars following burns or in chronic wounds, such as an untreated pilonidal cyst. The aim of the present technical note is to describe a surgical technique aimed at minimizing local recurrence rates by en-bloc resection as well as providing immediate plastic reconstruction: 1. right-sided extended vertical rectus abdominis myo-cutaneous (VRAM) flap; 2. abdomino-perineal excision of the rectum with end colostomy; 3. en-bloc excision of the mass inclusive of gluteus maximus muscles and distal sacrectomy; 4. sacrectomy defect covered with VRAM flap; 5. bilateral gluteal defects covered with single-layer dermal substitute of bovine collagen and elastin hydrolysate followed by immediate split-thickness skin grafting from bilateral thigh donor sites, and negative pressure wound therapy dressings. This approach resulted in a favorable outcome at 2-year follow-up in a male patient presenting with a large locally advanced sacral squamous cell carcinoma involving the external anal sphincter muscle.

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Data are available upon request from qualified entity.

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Acknowledgements

No funding was acquired for this article.

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Authors and Affiliations

  1. Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

    Daniel Moritz Felsenreich, Mahir Gachabayov & Roberto Bergamaschi

  2. Section of Plastic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

    Edmond Ritter

  3. Department of Surgery, New York City Health Hospitals, Jacobi Medical Center, Suite 610, 1400 Pelham Parkway South, New York, NY, 10461, USA

    Roberto Bergamaschi

Authors
  1. Daniel Moritz Felsenreich
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  2. Mahir Gachabayov
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  3. Edmond Ritter
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  4. Roberto Bergamaschi
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Contributions

Conception and design: RB. Administrative support: MG, RB, ER. Provision of study material or patients: MG, AK. Collection and assembly of data: DMF, MG. Data analysis and interpretation: DMF, ER, RB. Manuscript writing: DMF, MG. Final approval of manuscript: DMF, AK, MG, ER, RB.

Corresponding author

Correspondence to Roberto Bergamaschi.

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None of the authors have any conflict of interest to declare.

Ethical statement

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images.

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Felsenreich, D.M., Gachabayov, M., Ritter, E. et al. En-bloc excision of sacral squamous cell carcinoma with immediate reconstruction. Updates Surg (2024). https://doi.org/10.1007/s13304-024-01861-z

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  • DOI: https://doi.org/10.1007/s13304-024-01861-z

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