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Fate Mapping of Human Embryonic Stem Cells by Teratoma Formation
Published on: August 1, 2010
Damage control operation for massive sacrococcygeal teratoma
C Jason Smithers1, Patrick J Javid, Christopher G Turner
1Department of Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
Journal of Pediatric Surgery
|March 8, 2011
Summary
Massive sacrococcygeal teratomas (SCTs) can cause life-threatening cardiac instability in fetuses. A damage-control surgical approach successfully managed hemorrhage, enabling staged resection and patient recovery.
Area of Science:
- Fetal Surgery
- Pediatric Surgery
- Surgical Oncology
Background:
- Massive sacrococcygeal teratomas (SCTs) present significant surgical risks, including hemodynamic instability and hemorrhage.
- Fetal SCTs can lead to high-output cardiac failure in utero.
Observation:
- A fetus at 32 weeks' gestation exhibited high-output cardiac instability due to a massive SCT.
- Urgent cesarean delivery was performed, followed by a damage-control operation.
Findings:
- Teflon-pledgeted mattress sutures were employed to achieve hemodynamic control of tumor bleeding.
- A staged resection, including the pelvic portion, was successfully completed one week post-delivery after stabilization.
- The patient demonstrated positive outcomes, discharged on postoperative day 30 and well at 30 months.
Implications:
- Damage-control surgery can effectively manage hemorrhage in massive fetal SCTs.
- Staged resection allows for stabilization and complete tumor removal in complex cases.
- This approach offers a viable strategy for improving outcomes in neonates with high-risk SCTs.