Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Pediatr Surg Int. 2020 Nov;36(11):1327-1332. doi: 10.1007/s00383-020-04752-7. Epub 2020 Sep 29.
This study aimed to evaluate the incidence and factors associated with long-term functional outcomes of sacrococcygeal teratoma (SCT) after resection in neonates and infants.
Twenty-nine patients with a minimum of 3 years of follow-up who underwent resection and were histologically diagnosed with SCTs between 1982 and 2017 at our institution were included.
The median age at the time of the study was 10.0 years. Functional disorders occurred after surgery in 6 (20.7%) patients. Anorectal dysfunction, urologic dysfunction, and lower-extremity motor disorders occurred in 6 (20.7%), 4 (13.8%), and 3 (10.3%) patients, respectively. One patient with all three types of functional disorders developed intestinal perforation due to ileus and died of sepsis at 13 years of age. The overall mortality rate after tumor resection was 3.4%. The patients who developed functional disorders presented a low 1-min Apgar score, larger tumors requiring abdominosacral resection, surgical injury to the pelvic organs, and immature or malignant histological findings.
Although the mortality rate was low, the long-term rate of functional disorders after SCT resection was approximately 20%. SCT patients with large tumors, surgical injury to the pelvic organs, and immature or malignant histological findings require thorough follow-up.
本研究旨在评估新生儿和婴儿行骶尾部畸胎瘤（SCT）切除术后长期功能结局的发生率及相关因素。
回顾性分析 1982 年至 2017 年在我院接受手术切除且至少随访 3 年的 29 例组织学诊断为 SCT 的患者。
研究时的中位年龄为 10.0 岁。6 例（20.7%）患者术后出现功能障碍。6 例（20.7%）出现肛肠功能障碍，4 例（13.8%）出现泌尿系统功能障碍，3 例（10.3%）出现下肢运动障碍。1 例具有上述 3 种功能障碍的患者因肠梗阻导致肠穿孔，13 岁时死于败血症。肿瘤切除后总死亡率为 3.4%。发生功能障碍的患者 1 分钟 Apgar 评分较低，肿瘤较大需要经腹骶联合切除，手术损伤盆腔器官，组织学检查不成熟或为恶性。
尽管死亡率较低，但 SCT 切除术后长期功能障碍的发生率约为 20%。肿瘤较大、损伤盆腔器官和组织学检查不成熟或恶性的 SCT 患者需要彻底随访。
