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Functional fecal and urinary outcomes after sacrococcygeal mass resection in pediatric patients
Hira Ahmad1, Devin R Halleran1, Jon Vardanyan1
1Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
Insights
A multidisciplinary clinic approach significantly improves bowel and bladder continence outcomes for children after sacrococcygeal mass resection. This coordinated care enhances functional results for pediatric patients.
Area of Science:
- Pediatric Surgery
- Oncology
- Urology
Background:
- Sacrococcygeal masses (SCM) are rare pediatric tumors.
- Surgical resection is the primary treatment for SCM.
- Functional outcomes, particularly bowel and urinary continence, are critical post-resection.
Purpose of the Study:
- To evaluate functional fecal and urinary outcomes after SCM resection.
- To assess the impact of a multidisciplinary clinic (MDC) on these outcomes.
Main Methods:
- Retrospective review of 75 patients undergoing SCM resection (1979-2019).
- Assessment of fecal and urinary continence using validated scales (BCS, VSS, CSS).
- Analysis of patient demographics, tumor characteristics, and anorectal malformations (ARM).
Main Results:
- 56% of patients were followed in the MDC.
- MDC patients showed significantly higher rates of fecal (82% vs. 59%) and urinary (87% vs. 59%) continence.
- Improvement observed in Baylor, Vancouver, and Cleveland scores for MDC patients.
Conclusions:
- A multidisciplinary approach to SCM care may enhance functional bowel and bladder outcomes.
- Coordinated care in an MDC setting is associated with improved continence post-SCM resection.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
A multidisciplinary approach to the care of patients following SCM resection may improve bowel and bladder outcomes.
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