Laparoscopic-assisted Combined Abdominal and Sacral Approach for Sacrococcygeal Teratoma Altman II/III Excision: Case Series.

CONTEXT

This study aims to optimize patient outcomes and surgical efficacy by integrating laparoscopic and sacral approaches for the excision of presacral teratomas, focusing on Altman type II-III classifications.

METHODS

A case series was conducted with seven patients diagnosed with sacrococcygeal teratoma (SCT) Altman type II-III. Short- and intermediate-term surgical outcomes were assessed following a combined laparoscopic and sacral approach. The diagnosis was based on clinical examination, elevated serum alpha-fetoprotein levels, and preoperative pelvic magnetic resonance imaging classification. The study evaluates the safety and efficacy of this surgical method, emphasizing feasibility and potential benefits for treating presacral teratomas of varying complexity.

RESULTS

The age of patients ranged from 8 days to 1.5 years, with a mean age of 115.93 ± 192.3 days. The average duration of surgery was 2.7 h (range: 2-3.15 h), with no intraoperative bleeding. Postoperative recovery was smooth; 71.43% of patients resumed a full diet within 3 days, while the remaining patients did so within 4 days. One patient experienced mild skin erythema, managed conservatively, and two patients had perineal wound separation, resolved with topical treatment. The median hospital stay was 7 days (range: 5-78 days). No postoperative urinary or stool incontinence was observed.

CONCLUSIONS

The combined laparoscopic and posterior sacral approach is a safe and reliable method for the excision of SCTs, potentially improving patient outcomes and reducing postoperative complications.