Surgical Management of Presacral Tumors: Report of 5 Cases With Video Vignette of Laparoscopic Removal

Background: Cystic tumors in the presacral space represent a rare pathology. In case of symptoms, but particularly due to the danger of malignant degeneration, surgical removal is indicated. Due to the complex position in the pelvis with its proximity to important anatomic structures, the choice of the surgical approach is decisive. Methods: To present an overview of the recent knowledge of presacral tumors, a PubMed-based literature review was performed. Subsequently, we present 5 cases where different surgical strategies were evaluated including a video of a laparoscopic removal. Results: Presacral tumors can be of different histopathologic origins. Complete surgical excision is the treatment of choice, with open abdominal, open abdominoperineal, and posterior accesses available, as well as minimally invasive techniques. Conclusion: Laparoscopic resection of presacral tumors is a well-suitable option, but the decision must always be made individually.