Long-Term Outcome of Sacrococcygeal Teratoma: A Controlled Cohort Study of Urinary Tract and Bowel Dysfunction and Predictors of Poor Outcome

J Pediatr. 2018 Jul:198:131-136.e2. doi: 10.1016/j.jpeds.2018.02.031. Epub 2018 Apr 12.

Abstract

Objective: To evaluate urinary tract and bowel function in children with sacrococcygeal teratoma, compare the findings with healthy children, and assess predictors of poor outcome.

Study design: This was a controlled cohort study of all patients operated for sacrococcygeal teratoma at a tertiary pediatric surgery center, 2000-2013. Urinary and bowel function were compared with healthy control patients matched for age and sex. Perioperative and histopathologic risk factors were analyzed.

Results: In total, 17 patients with sacrococcygeal teratoma and 85 healthy control patients were included in the study. Patients with sacrococcygeal teratoma more often were reported to have uncontrolled voiding (12% vs 0%, P < .01), difficulty in bladder emptying (24% vs 0%, P < .001), and pyelonephritis (18% vs 1%, P < .05). Constipation was more common in patients with sacrococcygeal teratoma (47 % vs 14%, P < .05), but the overall bowel function score was equal in the 2 groups. Children with large tumors and immature histology were more likely to have a dysfunctional outcome (P < .05).

Conclusions: Uncontrolled voiding, difficulty in bladder emptying, pyelonephritis, and constipation were more common in patients with sacrococcygeal teratoma than in healthy children. Dysfunctional outcome was more prevalent in children with large and immature teratomas.

Keywords: bowel dysfunction; complications; follow-up; healthy controls; risk factors; sacrococcygeal teratomas; urinary tract dysfunction.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Intestinal Diseases / epidemiology*
  • Male
  • Postoperative Complications / epidemiology*
  • Sacrococcygeal Region*
  • Soft Tissue Neoplasms / complications
  • Soft Tissue Neoplasms / surgery*
  • Teratoma / complications
  • Teratoma / surgery*
  • Treatment Outcome
  • Urologic Diseases / epidemiology*