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[Sacral teratomas in childhood. An analysis of long-term results in 87 children]
R Engelskirchen1, A M Holschneider, R Rhein
1Kinderchirurgische Klinik des Kinderkrankenhauses der Stadt Köln.
Insights
Sacrococcygeal teratoma surgery can lead to bladder and rectal dysfunction in children. Further testing revealed issues in 40% of patients, linked to tumor characteristics.
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Urology
Context:
- Sacrococcygeal teratomas are congenital tumors affecting newborns.
- Long-term outcomes for treated children are crucial for understanding developmental impact.
- Assessing functional sequelae requires detailed investigation beyond clinical exams.
Purpose:
- To evaluate long-term functional outcomes, specifically bladder and rectal function, in children treated for sacrococcygeal teratomas.
- To determine the prevalence and nature of post-operative dysfunctions.
- To correlate these dysfunctions with tumor characteristics and surgical history.
Summary:
- A 25-year follow-up study included 52 children with sacrococcygeal teratomas (out of 87 total), focusing on 35 survivors operated on over three years prior.
- Clinical examination alone in 18 children revealed no dysfunctions.
- However, electromanometry testing in 17 additional children identified bladder and rectal dysfunctions in approximately 40%, attributed to myogenic and neurogenic factors related to tumor size, status, and intrapelvic extension.
Impact:
- This study highlights the importance of specialized testing for detecting subtle functional deficits after sacrococcygeal teratoma treatment.
- Findings suggest that tumor characteristics significantly influence the risk of developing long-term bladder and rectal dysfunctions.
- Results can inform surgical strategies and post-operative monitoring protocols to improve functional outcomes in pediatric patients.
Abstract:
52 patients were followed up out of a total of 87 children with sacrococcygeal teratomas, within a period of 25 years, from three paediatric surgery hospitals and out of altogether 73 survivors. The results in 35 children where the operation had been performed more than three years ago, were classified as "late results". From this group, 18 children were followed up by clinical examination only, without detecting any dysfunctions. By the additional use of electromanometry of urinary bladder and rectum, however, bladder and rectum dysfunctions were seen in about 40% of 17 further children. These dysfunctions were partly myogenic and partly neurogenic in nature and were directly related to the size, tumour status and intrapelvic extension of the sacrococcygeal teratoma.