Havránek P, Hedlund H, Rubenson A, Güth D, Husberg M, Frykberg T, Larsson L T
Department of Pediatric Surgery, East Hospital, University of Göteborg, Sweden.
J Pediatr Surg. 1992 Jul;27(7):916-8. doi: 10.1016/0022-3468(92)90398-q.
Thirty-four patients operated with sacrococcygeal teratoma in Sweden between 1978 and 1989 were reviewed. Twenty-five children were available for functional follow-up. The patients and their parents were interviewed for bowel and micturition habits. Fourteen patients from this number were subjected to anorectal manometry (56%). Fifteen children reported normal bowel habits (60%). In 10 patients (40%) soiling was observed. However, four of them were under 3 years of age and wearing diapers, which made the functional evaluation difficult. The manometries showed normal and resting tone and squeezing pressures in 10 patients and subnormal values in four patients who also had soiling problems. All investigated children showed normal rectoanal inhibition reflex. Twenty-one patients reported normal micturition, in four (16%) urinary incontinence was recorded. Two of the latter children required intermittent clean catheterization, one was on medication and the last one lives without any treatment. No difference in functional outcome was noted between patients with intrapelvic or extrapelvic tumor location. Retrospectively, it is not possible to know whether the observed functional outcome is due to tumor growth or the result of surgery. Preoperative clinical investigation and in some cases anorectal manometry and cystometry could theoretically resolve this problem.
对1978年至1989年间在瑞典接受骶尾部畸胎瘤手术的34例患者进行了回顾性研究。25名儿童可进行功能随访。对患者及其父母就排便和排尿习惯进行了访谈。其中14例患者接受了肛门直肠测压（56%）。15名儿童报告排便习惯正常（60%）。10例患者（40%）存在便失禁情况。然而，其中4例年龄在3岁以下且仍在使用尿布，这使得功能评估变得困难。测压显示，10例患者的静息张力和挤压压力正常，4例存在便失禁问题的患者数值低于正常。所有接受调查的儿童直肠肛门抑制反射均正常。21例患者报告排尿正常，4例（16%）记录有尿失禁。后4例儿童中，2例需要间歇性清洁导尿，1例接受药物治疗，最后1例未接受任何治疗。盆腔内或盆腔外肿瘤位置的患者在功能结局上未发现差异。回顾性来看，无法确定所观察到的功能结局是由于肿瘤生长还是手术结果所致。术前临床检查以及在某些情况下进行的肛门直肠测压和膀胱测压理论上可以解决这个问题。
