39-year-old Ms. Liu has suffered from sacrococcygeal pain since she was a child. She has been seeking medical treatment everywhere for decades, but failed to recover after many surgical treatments. Ms. Liu was sent to The Sixth Affiliated Hospital of Sun Yat-sen University for treatment. Ren Donglin, Department of Anorectal Surgery With his rich clinical experience, the professor uncovered the disease that Ms. Liu suffered from and led the team to relieve her pain.
The pictures and text are not relevant, only for illustrations
14 operations failed to cure the final diagnosis of presacral teratoma
During Ms. Liu's medical treatment, she was diagnosed with anal fistula, perianal abscess, osteomyelitis and other diseases. , underwent 14 major and minor surgical treatments, but was never cured. After being introduced to the Anorectal Surgery Department of the Sixth Affiliated Hospital of Sun Yat-sen University, he was finally diagnosed with presacral teratoma.
Professor Ren Donglin said that presacral teratoma is a type of presacral cyst, and its incidence is very low. In tertiary medical centers, there is an average of one presacral cyst patient per 40,000 to 60,000 people, and it is more common in female patients. Presacral cysts can be found in some patients during premarital and prenatal examinations.
About 26%-50% of patients with presacral cysts do not have any obvious symptoms in the early stage, but as the disease progresses, patients will develop symptoms such as masses, pain, and abscesses in the sacrococcygeal area. Presacral cysts are more serious. The probability of deterioration is very high. Generally, presacral cysts that are more than ten years old are prone to malignant transformation. Patients often lose the opportunity for surgical treatment and live with unbearable odor, seriously endangering the patient's quality of life and health.
Sacrococcygeal presacral cyst radical surgery solves patients’ worries
Professor Ren Donglin’s team conducted a detailed medical history inquiry and auxiliary examination on Ms. Liu and found that her condition was not optimistic. Due to long-term disease and repeated surgeries, Ms. Liu’s affected area has lost its original anatomical features. Scars left by previous surgeries are widely distributed, with obvious local redness, swelling, and tenderness. The anatomical relationships are complex and disordered. Undoubtedly, it makes the treatment more difficult. How to perform the surgery has become the most difficult problem that needs to be solved.
After a series of careful preoperative discussions and rehearsals, Professor Ren Donglin’s team decided to perform a transsacrococcygeal presacral cyst radical surgery to treat Ms. Liu. With the joint efforts of the team, the tumor that had troubled Ms. Liu for many years was completely removed. Fortunately, After pathological examination, it was confirmed that the tumor was a benign teratoma. Ms. Liu is currently recovering well.
Professor Ren Donglin said that transsacrococcygeal approach surgery is the most important surgical method for the treatment of presacral cysts. Compared with transabdominal approach surgery, transsacrococcygeal approach surgery is more direct, less damaging, and more thorough. Therefore, the chance of recurrence is also smaller. At the same time, the operation can preserve the anus and rectum for the patient. After professional postoperative sphincter repair treatment, the patient can still get a good quality of life.
Presacral cysts have a high misdiagnosis rate and great harm. Experts remind you to avoid detours and gain more benefits.
Patients who are misdiagnosed like Ms. Liu are not an exception. Because presacral cysts are very rare, many medical institutions also lack corresponding clinical experience. Presacral cysts It is easily missed or misdiagnosed, and is often treated as anal fistula, perianal abscess and other diseases. However, despite multiple anal fistula surgeries, not only the results are minimal, but the patient's local anatomical relationship becomes more complex and disordered, making subsequent treatment difficult. Severe cases may face the risk of anal and rectal resection, or even worsen the cyst and lose the opportunity for radical cure. .
It is understood that the Anorectal Surgery Department of Zhongshan Sixth Hospital has completed more than 160 such operations in the past ten years, and is the medical institution that has reported the most cases of this type of surgery in the world. However, among these cases, less than 10% are first diagnosed. According to statistics, on average, each patient has undergone 2.3 other surgeries before coming to the clinic, and many patients have lost the best opportunity for treatment.
In order to avoid detours for patients with presacral cysts and reduce the pain and financial pressure of patients and their families, Professor Ren Donglin reminds patients that special attention should be paid to the following points in the treatment and diagnosis of presacral cysts:
1. Clear diagnosis of sacral cysts Anterior cyst requires physical examination, MRI, CT, digital anal examination and other examinations. Because the lesion of presacral cyst is very deep, it is necessary to improve the imaging examination. Presacral cyst often appears as coccyx defect, Fusion and sacrum curvature decrease.
2. When a patient is diagnosed with anal fistula or perianal abscess and fails to recover through surgical treatment, he or she needs to be more vigilant and seek more accurate diagnosis and treatment from a higher-level medical unit to prevent missed diagnosis or misdiagnosis of presacral cyst.
3. Surgery is currently considered to be the only effective treatment for presacral cysts. Patients should choose observation or surgery according to the doctor's guidance during treatment. Blind treatment must not be allowed to delay the condition.
