Department of Pediatric Surgery, Skåne University Hospital, Lund and Institution of Clinical Research, Lund University, Lund, Sweden.
Department of Women's and Children's Health, Department of Pediatric Surgery, University Children's Hospital, Uppsala, Sweden.
J Pediatr Surg. 2019 Aug;54(8):1638-1643. doi: 10.1016/j.jpedsurg.2018.10.044. Epub 2018 Oct 22.
BACKGROUND/PURPOSE: The aims of this study were to evaluate bowel and urinary tract function, to identify predictors for dysfunctional outcome and to evaluate health-related quality-of life (QoL) in patients treated for sacrococcygeal teratomas (SCT).
Medical records of patients with SCT born between 1985 and 2015 treated at three Swedish pediatric surgical centers were reviewed. Questionnaires regarding urinary tract function, bowel function and QoL were sent to patients and parents. Different QoL instruments were used for the different age groups.
Totally 85 patients were identified. Four patients died in the neonatal period. Forty-nine patients answered the questionnaires (60%). Median age at follow-up was 8.9 years (range 3.6-28.8). Bowel dysfunction was reported by 36% and urinary tract dysfunction by 46% of the patients. Univariate analysis revealed that urinary tract dysfunction correlated with gestational age (p = 0.018) and immature histology (p = 0.008), and bowel dysfunction correlated with gestational age (p = 0.016) and tumor size (p = 0.042). Low gestational age was an independent predictor for both urinary tract and bowel dysfunction. Good or very good QoL was reported by 56% of children aged 4-7 years, 90% of children aged 8-17 years and 67% of the adults.
Although a considerable proportion of bowel and urinary tract dysfunction was found, the reported QoL was good in a majority of the patients with SCT. Low gestational age was found to be a predictor for bowel- and urinary tract dysfunction.
Level III.
背景/目的：本研究旨在评估接受骶尾部畸胎瘤（SCT）治疗的患者的肠道和泌尿道功能，确定功能障碍结局的预测因素，并评估其健康相关生活质量（QoL）。
回顾了 1985 年至 2015 年在瑞典三个小儿外科中心接受治疗的 SCT 患者的病历。向患者及其家长发送了关于泌尿道功能、肠道功能和 QoL 的调查问卷。不同的 QoL 工具用于不同的年龄组。
共确定了 85 名患者。4 名患者在新生儿期死亡。49 名患者（60%）回答了问卷。随访时的中位年龄为 8.9 岁（范围 3.6-28.8）。36%的患者报告存在肠道功能障碍，46%的患者报告存在泌尿道功能障碍。单因素分析显示，泌尿道功能障碍与胎龄（p=0.018）和不成熟的组织学（p=0.008）相关，而肠道功能障碍与胎龄（p=0.016）和肿瘤大小（p=0.042）相关。低胎龄是泌尿道和肠道功能障碍的独立预测因素。4-7 岁的儿童中，56%报告了良好或非常好的 QoL，8-17 岁的儿童中，90%报告了良好或非常好的 QoL，成年人中，67%报告了良好或非常好的 QoL。
尽管发现相当一部分患者存在肠道和泌尿道功能障碍，但大多数 SCT 患者报告的 QoL 良好。低胎龄是肠道和泌尿道功能障碍的预测因素。
III 级。
