骨肉瘤或直接盆腔癌侵犯骶骨代表部分或全部骶骨切除术的指征。目的是描述肿瘤手术管理和并发症情况，并分析骶骨切除术后我们自己的结果。在回顾性分析中，纳入了 27 名患者（n = 8/10/9 肉瘤/脊索瘤/局部复发直肠癌 (LRRC)） 。 9 例患者进行了全骶骨切除术（其中 2 例患者进行了 L5 整块脊柱联合切除术），10 例患者进行了部分骶骨切除术，8 例患者进行了半骶骨切除术。 12 名患者接受了导航辅助切除。为了重建，分别对 20、10 和 13 名患者进行了网膜成形术、VRAM 皮瓣或脊柱骨盆固定术。中位随访 (FU) 为 15 个月，FU 率为 93%。 81.5% 的患者进行了 R0 切除（使用导航无显着差异），81.5% 的患者出现一种或多种轻微至中度并发症（尤其是伤口愈合障碍/感染）。中位总生存期为 70 个月。 20% 的患者出现局部复发，44% 的患者出现转移，5 名患者死于疾病。骶骨肿瘤的切除具有挑战性，并且并发症较多。内脏/血管和整形外科的跨学科合作至关重要。在脊索瘤患者中，与 LRRC 和肉瘤相比，全身肿瘤控制效果更好。导航在术中定向方面提供了好处，即使目前似乎没有肿瘤学益处。完整的手术切除可为因各种复杂疾病而接受骶骨切除术的患者提供长期生存。

Bone sarcoma or direct pelvic carcinoma invasion of the sacrum represent indications for partial or total sacrectomy. The aim was to describe the oncosurgical management and complication profile and to analyze our own outcome results following sacrectomy.In a retrospective analysis, 27 patients (n = 8/10/9 sarcoma/chordoma/locally recurrent rectal cancer (LRRC)) were included. There was total sacrectomy in 9 (incl. combined L5 en bloc spondylectomy in 2), partial in 10 and hemisacrectomy in 8 patients. In 12 patients, resection was navigation-assisted. For reconstruction, an omentoplasty, VRAM-flap or spinopelvic fixation was performed in 20, 10 and 13 patients, respectively.With a median follow-up (FU) of 15 months, the FU rate was 93%. R0-resection was seen in 81.5% (no significant difference using navigation), and 81.5% of patients suffered from one or more minor-to-moderate complications (especially wound-healing disorders/infection). The median overall survival was 70 months. Local recurrence occurred in 20%, while 44% developed metastases and five patients died of disease.Resection of sacral tumors is challenging and associated with a high complication profile. Interdisciplinary cooperation with visceral/vascular and plastic surgery is essential. In chordoma patients, systemic tumor control is favorable compared to LRRC and sarcomas. Navigation offers gain in intraoperative orientation, even if there currently seems to be no oncological benefit. Complete surgical resection offers long-term survival to patients undergoing sacrectomy for a variety of complex diseases.