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Oral Presentation - 84
Long-Term Outcomes in children operated on for a Sacrococcygeal Teratoma
Bochra Aziza, Yasmine Houas, Nour Ben Alaya, Aroussia Dridi, Fatma Thamri, Asma Guitouni, Yosra Kerkeni, Sondes Sahli, Riadh Jouini
children hospital Bechir Hamza, Pediatric surgery department A Tunis Tunisia
Introduction:
Sacrococcygeal teratomas (SCTs) are uncommon germ cell tumors found in children. While the immediate surgical treatment of these tumors is well-established, there is a lack of comprehensive data on the long-term effects of SCT resection on urinary and bowel function.
Aim of the study:
To evaluate urinary and bowel function outcomes in children following SCT resection.
Materials and methods
A retrospective review of medical records for neonates diagnosed with SCT who underwent surgical resection between January 2000 and December 2019. We assessed postoperative outcomes through a combination of clinical follow-up and patient-reported data. Long-term follow-up extended to a minimum of 5 years post-surgery.
Results:
Our study included 26 patients. The median age at diagnosis was 4,7day [The sex ratio was 3.1, with 15 females and 11 males. Antenatal diagnosis was made in 13 cases (28.3%). The average gestational age was 36.5 weeks, and the mean birth weight was 3117 g (range: 2250-4580 g). Preoperative alpha-fetoprotein levels averaged 29.327 ng/mL (range: 649.7-110,600 ng/mL). The median age at surgery was 10 days. Surgical procedures included primary tumor resection and coccygectomy. Among the tumors, 14(54.3%) were classified as Altman type II, 4 (15.2%) as type IV, and 8(30.7%) as types I and III. Histological findings showed benign tumors in 20 cases (78.2%) and immature tumors in 6 cases (21.7%). Follow-up data were available for 18 patients, with an average follow-up duration of 119.4 months (range: 30-146 months). Five cases of recurrence involving high-grade immature teratomas were noted, with recurrences occurring at a median age of 13 months [IQR: 8.75-30 months]. Additionally, three patients experienced urinary incontinence or bowel dysfunction.
Conclusion:
Sacrococcygeal teratomas, while rare, are associated with frequent postoperative complications. Long-term follow-up indicates that recurrences, especially in high-grade immature forms, are possible, and some patients may experience persistent urinary or bowel dysfunction.