Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
Division of Hematology, Oncology, and Bone Marrow Transplantation, Nationwide Children's Hospital, Columbus, OH, United States.
J Pediatr Surg. 2021 Jun;56(6):1142-1147. doi: 10.1016/j.jpedsurg.2021.02.028. Epub 2021 Feb 23.
Sacrococcygeal masses (SCM) are uncommon in children. The purpose of this study is to review the functional fecal and urinary outcomes following resection of SCM and to determine the impact of a multidisciplinary clinic (MDC) on these outcomes.
A retrospective review was performed of patients who underwent SCM resection between 1979 and 2019. Baylor Social Continence Scale (BCS), Vancouver Symptom Score (VSS) and Cleveland constipation score (CSS) surveys were used to assess fecal and urinary continence at time of most recent follow up. Age, tumor characteristics, histopathology, and type of anorectal malformations (ARM), if present, were also recorded.
75 patients were included. 51 (69%) patients were females and 23 (31%) had an associated ARM. The median age at resection was 8.5 months (IQR 0-26.8). 41 (56%) patients were followed in the MDC. 27 (82%) of patients seen in the MDC were clean for stool and 26 (87%) were dry for urine, while only 17 (59%) of patients not seen in the MDC were clean for stool and dry for urine (p<0.05). There was improvement in Baylor, Vancouver and Cleveland scores.
A multidisciplinary approach to the care of patients following SCM resection may improve bowel and bladder outcomes.
尾骨直肠部肿块（SCM）在儿童中较为少见。本研究旨在回顾 SCM 切除术后的功能性粪便和尿液结果，并确定多学科诊疗（MDC）对这些结果的影响。
对 1979 年至 2019 年间接受 SCM 切除术的患者进行回顾性分析。采用 Baylor 社会节制量表（BCS）、温哥华症状评分（VSS）和克利夫兰便秘评分（CSS）对最近随访时的粪便和尿液节制情况进行评估。同时记录年龄、肿瘤特征、组织病理学以及存在的肛门直肠畸形（ARM）类型。
共纳入 75 例患者，其中 51 例（69%）为女性，23 例（31%）存在合并的 ARM。切除时的中位年龄为 8.5 个月（IQR 0-26.8）。41 例（56%）患者在 MDC 中接受随访。在 MDC 中接受治疗的 27 例（82%）患者粪便清洁，26 例（87%）尿液干燥，而未在 MDC 中接受治疗的 17 例（59%）患者粪便清洁且尿液干燥（p<0.05）。Baylor、Vancouver 和 Cleveland 评分均有改善。
对 SCM 切除术后患者进行多学科诊疗可能会改善肠道和膀胱功能。
