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Table 1 Advantages and disadvantages of each approach for presacral tumor resection

From: Surgical management for a huge presacral teratoma and a meningocele in an adult with Currarino triad: a case report

  Posterior approach Transabdominal approach
Advantages - Short distance to the tumor.
- Direct dissection around the coccyx or levator ani muscle.
- Coccygectomy can be added.
- Cranial side of large tumors (> 10 cm) can be exposed easily.
Disadvantages - Risk of injury to hypogastric nerves and median sacral vessels.
- Exposure of the cranial side of the tumor is difficult.
- Dissection around the lower rectum is difficult.
- Risk of injury to proximal part of the mesentery (which may require resection of the rectum and/or stoma creation).
- Risk of peritoneal dissemination.
- Risk of adhesive intestinal obstruction.