Postoperative evaluation of anorectal function in children with sacrococcygeal teratoma

Abstract

Objective To evaluate postoperative anorectal function in children with sacrococcygeal teratoma.Methods From January 1999 to October 2010,49 children with sacrococcygeal teratoma underwent surgeries in Shanghai Children's Medical Center.The anorectal function of the patients were followed-up with Krickenbeck classification.The sarne numbers of age-matched normal infants without anorectal operation were chosen as control group.The rates of anorectal dysfunction between different clinical and pathologic types,and different surgical approaches were compared.Mean diameters of tumors were also compared between normal and abnormal anorectal function groups.Results There were 49 cases of sacrococcygeal teratoma,all of them were treated by complete resection of the tumor.Among them,7 patients had anorectal dysfunction,including 2 cases of soiling (one had grade 2,and the other had grade 3 soiling,according to Krickenbeck classification),and 5 cases of constipation (3 had grade 1,and 2 had grade 2 constipation).In the control group,only one had constipation (grade 1 ).The incidence of anorectal dysfunction (including constipation and soiling) in the sacrococcygeal teratoma group was higher than that in control group (P＜0.05).In the 49 cases of sacrococcygeal teratoma,4 (2 bad roiling,and 2 had constipation) belonged to mixed type,2 ( both had constipation) were apparent type,and 1 (had constipation) was occult type.There was no statistical difference of anorectal function among different clinical or pathologic types of sacrococcygeal teratoma,nor in different surgical approach groups (P＞0.05).Statistical difference of diameters of tumors was not found in patients with or without anorectal dysfunction either (P＞0.05).Conclusions The rate of anorectal dysfunction in children with sacrococcygeal teratom treated by operation is high.But there is no definite correlation between anorectal function and clinical or pathologic types,and the size of tumor.It is important to proctect the pelvic plexus and anal sphincter during the operation,which is vital to the anorectal function. Key words: Teratoma; Sacrococcygeal region; Colorectal surgery