Objective: To investigate the causes and management of long-term persistent pelvic presacral space
infection .
Methods: Clinical data of 10
patients with persistent presacral
infection admitted to the
Cancer Hospital of Zhengzhou
University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral
infection according to the
patients ' initial
surgical procedures .
Results: Among the 10
patients , there were 2 cases of presacral
recurrent infection due to rectal leak after
radiotherapy for
cervical cancer , 3 cases of presacral
recurrent infection due to rectal leak after
radiotherapy for
rectal cancer Dixons, and 5 cases of presacral
recurrent infection of sinus tract after
adjuvant radiotherapy for
rectal cancer Miles. Of the 5
patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete
debridement of the presacral
infection using an anterior transverse sacral incision with a large tipped
omentum filling the presacral space; 1 had continuous
drainage of the
anal canal and complete
debridement of the presacral
infection using an anterior transverse sacral incision. 5 post-Miles
patients all had
debridement of the presacral
infection using an anterior transverse sacral incision combined with an abdominal incision. The nine
patients with healed presacral
infection recovered from
surgery in 26 to 210 days, with a median
time of 55 days.
Conclusions: Anterior sacral
infections in
patients with leaky gut are caused by residual bowel
secretion of intestinal fluid into the anterior sacral space, and in post-Miles
patients by residual anterior sacral
foreign bodies . An anterior sacral caudal transverse
arc incision combined with an abdominal incision is an effective surgical approach for complete
debridement of anterior sacral recalcitrant
infections .