本研究旨在阐明经腹微创手术（MIS）联合经会阴微创手术（tpMIS）对晚期原发性和复发性盆腔恶性肿瘤骶骨切除术的疗效和安全性。使用前瞻性收集的数据库，我们回顾性分析了临床、手术和MIS 与 tpMIS 进行骶管切除术的病理结果。手术于 2019 年 2 月至 2023 年 5 月期间进行。中位随访期为 27 个月（5-46 个月）。本次分析包含 15 名连续患者。诊断如下：复发性直肠癌，n = 11（73%）；原发性直肠癌，n = 3 (20%)；和复发性卵巢癌，n = 1 (7%)。七名患者（47%）接受盆腔廓清术联合骶骨切除术，六名患者（40%）接受腹会阴切除术（APR）联合骶骨切除术，两名患者（13%）接受肿瘤切除术联合骶骨切除术。术中失血量中位数为 235 毫升（范围 45-1320 毫升）。术后并发症（Clavien-Dindo分级 ≥ 3a）分级如下：3a，n = 6（40%）； 3b，n = 1（7%）；且≥ 4，n = 0 (0%)。病理检查显示13例患者（87%）达到R0。随访期间，两名患者（13%）因癌症复发而出现局部复发。其余13名患者（87%）无局部疾病。 14 名患者 (93%) 存活下来。尽管本研究中的患者队列存在异质性，但采用 tpMIS 的 MIS 与极少量的失血、严重术后并发症的发生率较低以及可接受的 R0 切除率相关。需要进一步研究来阐明长期肿瘤学可行性。© 2024。Springer Nature Switzerland AG。

This study aimed to clarify the efficacy and safety of minimally invasive transabdominal surgery (MIS) with transperineal minimal invasive surgery (tpMIS) for sacrectomy in advanced primary and recurrent pelvic malignancies.Using a prospectively collected database, we retrospectively analyzed the clinical, surgical, and pathological outcomes of MIS with tpMIS for sacrectomies. Surgery was performed between February 2019 and May 2023. The median follow-up period was 27 months (5-46 months).Fifteen consecutive patients were included in this analysis. The diagnoses were as follows: recurrent rectal cancer, n = 11 (73%); primary rectal cancer, n = 3 (20%); and recurrent ovarian cancer, n = 1 (7%). Seven patients (47%) underwent pelvic exenteration with sacrectomy, six patients (40%) underwent abdominoperineal resection (APR) with sacrectomy, and two patients (13%) underwent tumor resection with sacrectomy. The median intraoperative blood loss was 235 ml (range 45-1320 ml). The postoperative complications (Clavien-Dindo grade ≥ 3a) were graded as follows: 3a, n = 6 (40%); 3b, n = 1 (7%); and ≥ 4, n = 0 (0%). Pathological examinations demonstrated that R0 was achieved in 13 patients (87%). During the follow-up period, two patients (13%) developed local re-recurrence due to recurrent cancer. The remaining 13 patients (87%) had no local disease. Fourteen patients (93%) survived.Although the patient cohort in this study is heterogeneous, MIS with tpMIS was associated with a very small amount of blood loss, a low incidence of severe postoperative complications, and an acceptable R0 resection rate. Further studies are needed to clarify the long-term oncological feasibility.© 2024. Springer Nature Switzerland AG.