骶骨肿瘤因局部解剖复杂和巨大肿瘤常与盆腔内脏器粘连而增加了手术切除的难度。本文报告经腹和腰骶部联合入路切除2例骶骨巨大脊索瘤。 1 病例报告 1.1 例1.患者,女,45岁。因骶后部肿物伴疼痛2年于1995—04—16入院。查体:骶后偏右侧可见一新生儿头大肿物,皮肤无静脉怒张,质中等硬,轻度压痛,边界清楚,不活动。会阴部感觉和下肢活动正常。肛诊检查:胸膝位距肛门5 cm直肠后壁外可触及一巨大软组织肿物,与直肠壁粘连。X线片见骶3以下和尾骨骨质破坏。CT显示骶3以下骨质破坏和巨大软组织肿块影,向盆腔和坐骨大孔突出,直肠受压。诊断:骶骨肿瘤。于入院后第8天在硬膜外麻醉下行骶骨肿瘤切除术。先取仰卧位,取下腹左侧经腹直肌切口,进腹后先结扎骶中动脉和双侧髂内动脉,保护输尿管免受损伤。在直肠左侧切开侧腹 Due to the complex anatomy of local anatomy and the large tumors that often adhere to the internal organs of the pelvis, the tibial tumors are more difficult to remove. This article reports that two cases of giant sacral chordoma were resected by a combined approach to the abdomen and lumbosacral region. 1 Case report 1.1 Case 1. Patient, female, 45 years old. Due to the back of the orbital mass with pain for 2 years admitted to the hospital on the 1995-04-16. Physical examination: A neonatal head mass can be seen on the right side of the eyelid, and the skin is free of venous engorgement. It is of medium hardness, mild tenderness, clear boundaries, and inactivity. Perineal feeling and lower limb activities are normal. Anal examination: chest and knee from the anus 5 cm outside the rectal wall can touch a huge soft tissue mass, and rectal wall adhesion. X-ray film see below 3 and bone destruction of coccyx. CT showed bone destruction and massive soft-tissue mass below the iliac crest 3, protruding to the pelvic and ischial foramen, and rectal pressure. Diagnosis: sacral tumors. On the 8th day after admission, sacral tumor resection was performed under epidural anesthesia. First take a supine position, remove the abdomen through the rectus abdominis muscle incision, first into the abdominal ligament artery and bilateral internal iliac artery, to protect the ureter from injury. Cut the flank on the left side of the rectum