SURGICAL REPAIR OF RELAPSING SACRAL HERNIA AFTER PRESACRAL TUMOR RESECTION VIA POSTERIOR APPROACH (KRASKE PROCEDURE)

Authors

  • Rita GALAMA Surgery Department of Centro Hospitalar do Médio Tejo EPE, Tomar, Portugal http://orcid.org/0000-0002-9219-4388
  • Lúcio Lara SANTOS Experimental Pathology and Therapeutics Research Group and Surgical Oncology Department of Portuguese Institute of Oncology of Porto FG, EPE, Porto, Portugal http://orcid.org/0000-0002-0521-5655
  • Carlos Gonçalves DIAS Surgical Oncology Department of Portuguese Institute of Oncology of Porto FG, EPE, Porto, Portugal
  • Pedro MARTINS Surgical Oncology Department of Portuguese Institute of Oncology of Porto FG, EPE, Porto, Portugal http://orcid.org/0000-0003-2460-2746
  • Joaquim ABREU DE SOUSA Surgical Oncology Department of Portuguese Institute of Oncology of Porto FG, EPE, Porto, Portugal http://orcid.org/0000-0002-4988-6987

DOI:

https://doi.org/10.34635/rpc.999

Keywords:

herniorrhaphy, incisional hernia, surgical procedure, sacrococcygeal region

Abstract

Presacral tumors are rare and mostly congenital. If, on the one hand, the Kraske procedure ensures complete excision, reducing local recurrence, on the other hand, it has the development of an incisional sacral hernia as a complication. We present a case of a 44-year-old woman with a relapsing sacral hernia after a posterior approach (Kraske procedure) for the resection of a presacral extra-ovarian fibroma. We describe a surgical repair with dual mesh via a posterior open approach. Twelve months after this surgical procedure, the patient shows no signs of recurrence. To the best of our knowledge, this is the first report, in the literature, on surgical correction of presacral hernia after a Kraske procedure.

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Author Biography

Lúcio Lara SANTOS, Experimental Pathology and Therapeutics Research Group and Surgical Oncology Department of Portuguese Institute of Oncology of Porto FG, EPE, Porto, Portugal

Lúcio José de Lara Santos, MD, PhD, is senior surgeon, Professor of Surgical Oncology, former
director of the Digestive Pathology Unit, currently the coordinator of the Experimental Pathology
and Therapeutics Group and member of the PIO’s Surgical Oncology Department. He also serves
as Adviser of Oncology for ONCOCIR - Education and Care in Oncology, Angola.
Prof. Santos received MD degrees from both Agostinho Neto University, Angola, and Nova
University, Lisboa, Portugal. He received his PhD in Surgery and Oncobiology from Porto
University, Porto, Portugal. He served a fellowship in General Surgery at the Portuguese Institute
of Oncology and received specialized training in esophageal surgery at Leiden Academy and in
liver surgery at Hôpital Paul Brousse in Villejuif, France, and The University of Texas MD Anderson
Cancer Center in Houston, Texas.
Prof. Santos’ research interests include surgical oncology and carcinogenesis, working in Portugal
and Angola. As a Consultant Surgical Oncologist and General Surgeon in the Portuguese Institute
of Oncology (Digestive Pathology and Breast Cancer Unit), Prof. de Lara Santos conducts
research in experimental pathology and oncology, including gastrointestinal, breast cancer, and
cancers related to infections. He has extensive experience in organizing oncology facilities such as
chemotherapy, radiation therapy, and surgical oncology services, and in standardizing procedures
and teaching of general medicine, surgery, and oncology.
Additionally, Prof. de Lara Santos is the author or coauthor of nearly 60 peer-reviewed publications
in journals including Nature Communications, Annals of Oncology, BMC Cancer, British Journal of
Cancer, and Molecular Oncology.

References

1. Aranda-Narváez JM, González-Sánchez AJ, Montiel-Casado C, Sánchez-Pérez B, Jiménez-Mazure C, Valle-Carbajo M, Santoyo-Santoyo J. Posterior approach (Kraske procedure) for surgical treatment of presacral tumors. World J Gastrointest Surg. 2012 May 27;4(5):126-30. doi: 10.4240/wjgs.v4.i5.126. PMID: 22655127; PMCID: PMC3364338.
2. Westbrook KC, Lang NP, Broadwater JR, Thompson BW. Posterior surgical approaches to the rectum. Ann Surg. 1982 Jun;195(6):677-85. doi: 10.1097/00000658-198206000-00001. PMID: 7082059; PMCID: PMC1352653.
3. Ghellal, A., Trilling, B. & Faucheron, JL. The Kraske procedure: no more indications for benign lesions?. Tech Coloproctol 23, 607–608 (2019). https://doi.org/10.1007/s10151-019-02005-x

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Published

2023-06-23

Issue

No. 55 (2023): June

Section

Clinical Case

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