Table 1.

Advantages and disadvantages of each approach for presacral tumor resection

	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.