Abdominosacral resection for locally recurring rectal cancer

Figure 1 Radiological aspect of a local relapse infiltrating the coccix and lower sacral bone.

Figure 2 Preparation of skin flaps allows a complete exposure of maximus gluteus muscles.

Figure 3 After the level of sacral transaction is identified the sacrum is osteotomized using normally a proper hammer and scalpel.

Figure 4 The figure shows a section of sacral specimen after S2 osteotomy.

Figure 5 Example of a complex plastic reconstruction of the sacral area by a pedicled musculocutaneous flap and a thigh thin graft.