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[Combined abdominosacral excision of a giant-cell tumor of the os sacrum].

In 1967 Localio described a synchronous abdomino-sacral approach for resection of sacrococcygeal chordoma. The patient is placed in the lateral position with the left side up. The incision is carried from a point to the right of the midline above the pubis transversely across the rectus and then obliquely parallel to the inguinal ligament, to end at the midaxillary line. Mobilisation of the rectum and control of the pelvic vessels presents no difficulty. The sacrum is then exposed from the dorsal side by a transverse incision. The possibility to work simultaneously in the two operative fields affords excellent exposure and control of bleeding. This approach has been used by the authors for resection of an abundantly vascularized giant cell tumor of the sacrum.