Tian Song,Zhu Xiaocun,Xiao Shangjie,et al.Prenatal diagnosis and multidisciplinary treatment of neonatal sacrococcygeal teratoma[J].Journal of Clinical Pediatric Surgery,,21():844-849.[doi:10.3760/cma.j.cn101785-202206003-009]
Prenatal diagnosis and multidisciplinary treatment of neonatal sacrococcygeal teratoma
- Keywords:
- Prenatal Diagnosis; Teratoma/SU; Infant; Newborn; Interdisciplinary Studies
- Abstract:
- Objective To explore the prenatal diagnosis and multidisciplinary treatment (MDT) of neonatal sacrococcygeal teratoma (SCT).Methods From April 2015 to January 2021, clinical data were retrospectively reviewed for 35 children of neonatal SCT.The MDT team consisted of neonatal surgeons, prenatal physicians, ultrasonic specialists, obstetricians, neonatologists and pathologists.According to the tumor diameter, 34 children were divided into giant teratoma group (tumor diameter > 10 cm, 13 cases) and ordinary teratoma group (tumor diameter ≤ 10 cm, 21 cases).The differences in gender, gestational age, birth type, birth weight, length of hospital stay, postoperative complications and tumor properties were compared between the two groups.Results Thirty-three SCT cases were identified by MDT, and one case was detected after birth.All cases were timely operated.Postoperative pathology revealed mature teratoma (n=29, 85.3%) and immature teratoma (n=5, 14.7%).There were no significant differences in gestational age, mode of delivery, birth weight, wound healing and average length of hospital stay between the two groups (P>0.05).Wound dehiscence and infection were two major postoperative complications.The post-discharge follow-up period was 6 to 36 mpnths.There was no recurrence or obvious rectal dysfunction.Conclusion Prenatal diagnosis can timely and effectively detect SCT children.And MDT may improve the prognosis of neonatal SCT.
References:
[1] 李鑫, 王皓洁, 阿里木江·阿不都热依木, 等.产前诊断巨大骶尾部畸胎瘤1例[J].临床小儿外科杂志, 2018, 17(6):479-480.DOI:10.3969/j.issn.1671-6353.2018.06.018. Li X, Wang HJ, Alimjiango Abdureyim, et al.Prenatal diagnosis of giant sacrococcygeal teratoma:one case report[J].J Clin Ped Sur, 2018, 17(6):479-480.DOI:10.3969/j.issn.1671-6353.2018.06.018.
[2] Roybal JL, Moldenhauer JS, Khalek N, et al.Early delivery as an alternative management strategy for selected high-risk fetal sacrococcygeal teratomas[J].J Pediatr Surg, 2011, 46(7):1325-1332.DOI:10.1016/j.jpedsurg.2010.10.020.
[3] Seilern Und Aspang J, Burnand KM, Ong H, et al.Sacrococcygeal teratoma with intraspinal extension:A case series and review of literature[J].J Pediatr Surg, 2020, 55(10):2022-2025.DOI:10.1016/j.jpedsurg.2020.02.003.
[4] Ayed A, Tonks AM, Lander A, et al.A review of pregnancies complicated by congenital sacrococcygeal teratoma in the West Midlands region over an 18-year period:population-based, cohort study[J].Prenat Diagn, 2015, 35(11):1037-1047.DOI:10.1002/pd.4641.
[5] Arisoy R, Erdogdu E, Kumru P, et al.Prenatal diagnosis and outcomes of fetal teratomas[J].J Clin Ultrasound, 2016, 44(2):118-125.DOI:10.1002/jcu.22310.
[6] Barakat MI, Abdelaal SM, Saleh AM.Sacrococcygeal teratoma in infants and children[J].Acta Neurochir (Wien), 2011, 153(9):1781-1786.DOI:10.1007/s00701-011-1048-8.
[7] Yao W, Li K, Zheng S, et al.Analysis of recurrence risks for sacrococcygeal teratoma in children[J].J Pediatr Surg, 2014, 49(12):1839-1842.DOI:10.1016/j.jpedsurg.2014.09.036.
[8] 杜晓斌, 胡博, 戴春娟, 等.新生儿骶尾部畸胎瘤手术后肛门直肠功能的相关因素分析[J].临床小儿外科杂志, 2021, 20(1):39-43.DOI:10.12260/lcxewkzz.2021.01.008. Du XB, Hu B, Dai CJ, et al.Influencing factors of anorectal complications of sacrococcygeal ter-atoma in neonates[J].J Clin Ped Sur, 2021, 20(1):39-43.DOI:10.12260/lcxewkzz.2021.01.008.
[9] Jan IA, Khan EA, Yasmeen N, et al.Posterior sagittal approach for resection of sacrococcygeal teratomas[J].Pediatr Surg Int, 2011, 27(5):545-548.DOI:10.1007/s00383-011-2870-z.
[10] Sarbu I, Socolov D, Socolov R, et al.Hydrocephalus secondary to chemotherapy in a case of prenatally diagnosed giant immature grade 3 sacrococcygeal teratoma:A case report and literature review[J].Medicine (Baltimore), 2016, 95(43):e5244.DOI:10.1097/MD.0000000000005244.
[11] Lee JK, Towbin AJ.Currarino syndrome and the effect of a large anterior sacral meningocele on distal colostogram in an anorectal malformation[J].J Radiol Case Rep, 2016, 10(6):16-21.DOI:10.3941/jrcr.v10i6.2068.
[12] 桂琳玲, 鲁巍, 方琼, 等.新生儿Currarino综合征并发尿潴留四例并文献复习[J].中华小儿外科杂志, 2020, 41(7):650-656.DOI:10.3760/cma.j.cn421158-20190825-00511. Gui LL, Lu W, Fang Q, et al.Neonatal Currarino syndrome with urinary retention:a report of 4 cases with a literature review[J].Chin J Pediatr Surg, 2020, 41(7):650-656.DOI:10.3760/cma.j.cn421158-20190825-00511.
[13] 李颀, 张震, 姜茜, 等.腹腔镜辅助治疗Currarino综合征的研究及中期功能评估[J].中华小儿外科杂志, 2020, 41(10):906-913.DOI:10.3760/cma.j.cn421158-20190725-00455. Li Q, Zhang Z, Jiang Q, et al.Mid-term outcomes of laparoscopic-assisted pull-through for Currarino syndrome[J].Chin J Pediatr Surg, 2020, 41(10):906-913.DOI:10.3760/cma.j.cn421158-20190725-00455.
[14] 王展, 唐达星.胎儿骶尾部畸胎瘤的预后评估研究进展[J].中华小儿外科杂志, 2016, 37(9):706-410.DOI:10.3760/cma.j.issn.0253-3006.2016.09.016. Wang Z, Tang DX.Advances in the prognostic predications of fetal sacrococcygeal teratoma[J].Chin J Pediatr Surg, 2016, 37(9):706-410.DOI:10.3760/cma.j.issn.0253-3006.2016.09.016.
[15] Nam SH, Cho MJ, Kim DY, et al.Half-life of alpha-fetoprotein in neonatal sacrococcygeal teratoma[J].J Pediatr Surg, 2018, 53(12):2470-2474.DOI:10.1016/j.jpedsurg.2018.08.012.
Memo
收稿日期:2021-06-25。
基金项目:广东省科技厅科技计划项目(2017ZC0315)
通讯作者:葛午平,E-mail:gewupingdoctor@sina.com