Sacrococcygeal teratomas: midline reconstruction improves cosmesis without compromising outcomes

Area of Science:

• Pediatric Surgery
• Surgical Oncology
• Plastic Surgery

Background:

• Sacrococcygeal teratoma (SCT) excision outcomes are well-documented, but cosmetic results of reconstruction are less explored.
• Classical chevron incisions can lead to unsatisfactory cosmetic outcomes.
• Midline reconstruction is preferred at our institution to improve appearance without affecting oncological or functional results.

Purpose of the Study:

• To evaluate patient-perceived cosmetic outcomes following sacrococcygeal teratoma excision using a midline reconstruction approach.

Main Methods:

• A retrospective study of patients undergoing SCT surgery between 2007 and 2020.
• Patient demographics, operation type, functional outcome, and recurrence were recorded.
• Cosmetic satisfaction was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a Patient Scar Assessment Questionnaire.

Main Results:

• Thirty-two patients underwent SCT surgery; 24 had posterior approach with midline reconstruction.
• No recurrences were observed; minor urological or bowel symptoms occurred in a small percentage.
• High patient/parent satisfaction reported, with 95% stating scars did not affect activities and 71% not conscious of the scar.

Conclusions:

• Scars from sacrococcygeal teratoma surgery can have significant cosmetic, functional, and psychological impacts.
• Midline reconstruction demonstrates a cosmetically favorable outcome in SCT excision.
• A midline reconstruction approach is recommended when appropriate for sacrococcygeal teratoma surgery.