title: Neurological outcome following resection of benign presacral neurogenic tumors using a nerve-sparing technique.
abstract: BACKGROUND
  Benign presacral nerve sheath tumors represent up to 10% of all presacral tumors. Limited data exist regarding the impact of the surgical technique on neurological outcomes following resection.
  
  
  OBJECTIVE
  The aim of this study was to test our hypothesis that a nerve-sparing resection technique results in the improvement of preoperative neurological dysfunction and minimal postoperative neurological morbidity.
  
  
  METHODS
  This study is a case series of all patients with benign neurogenic presacral tumors operated on by the same 2 surgeons between 2004 and 2010 at our institution.
  
  
  METHODS
  This study was performed at a tertiary care center.
  
  
  METHODS
  Adult patients with benign presacral neurogenic tumors who underwent a nerve-sparing resection were included.
  
  
  METHODS
  Postoperative urogenital, anorectal, and lower-extremity neurological functions were analyzed.
  
  
  RESULTS
  Seventeen patients were identified with a mean age of 40 years; 14 were women. Preoperatively, 13 patients had symptoms from neurological dysfunction or presumed mass effect of the tumor. The mean tumor size was 7.4 cm. The pathology was a schwannoma in 12 patients and neurofibroma in 5 patients. Mortality was nil, and 30-day morbidity was noted in 3 patients (hemorrhage, ileus, acute respiratory distress syndrome, deep vein thrombosis, and transient foot drop). Mean follow-up was 36 months. Of the 13 symptomatic patients, 7 achieved complete resolution of symptoms and 5 had improved, but persistent symptoms. None of the 4 asymptomatic patients developed postoperative neurological dysfunction.
  
  
  CONCLUSIONS
  Small sample size was a limitation of this study.
  
  
  CONCLUSIONS
  With the use of a nerve-sparing technique, function-preserving resection can be safely completed with an overall improvement in symptoms.
authors.affiliation: 1 Mayo Clinic, Department of Neurologic Surgery, Rochester, Minnesota 2 Mayo Clinic, Division of Colon and Rectal Surgery, Rochester, Minnesota.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Hébert-Blouin
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.forename: Amit
authors.initials: A
authors.lastname: Merchea
authors.forename: Daniel
authors.initials: D
authors.lastname: Léonard
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Dozois
mesh_terms: D000293:Adolescent; D000328:Adult; D003248:Constipation / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000601:surgery; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D009455:Neurofibroma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000601:surgery; D012585:Sciatica / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D047368:Tumor Burden; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery; D055815:Young Adult