Laparoscopic-assisted excision of sacrococcygeal teratoma in children.
BACKGROUND
Sacrococcygeal teratoma (SCT) is one of the most common tumors encountered in the neonatal period. Traditionally, a large abdominal incision is required for the combined abdominal perineal approach for the complete resection of type II-IV tumors. In this paper, we report our experience of using the combined laparoscopic perineal approach in treating these tumors.


METHODS
Between November 2000 and September 2004, 4 patients with SCT were treated by the combined approach. The operation was started with the laparoscopic mobilization of the pelvic part of the tumor, followed by the completion excision and tumor retrieval through the perineal route.


RESULTS
The operation was successfully completed in all patients, with a mean operative time of 279 minutes. There was no complication related to the laparoscopic dissection. Postoperative recovery was uneventful in all patients, except in 1 with a minor wound problem. At a median follow-up of 46.5 months, there was no recurrence encountered in all these patients and the cosmetic result was excellent. Functional outcome was satisfactory, except in the patient with spinal metastases.


CONCLUSIONS
The combined laparoscopic and perineal approach provides a safe, excellent access in removing type II-IV SCT in infants.
Lee
Kim Hung
KH
Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. drkhlee@hotmail.com
Tam
Yuk Him
YH
Chan
Kin Wai
KW
Cheung
Shing Tak
ST
Sihoe
Jennifer
J
Yeung
Chung Kwong
CK
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D010386:Pelvic Neoplasms / Q000151:congenital / Q000601:surgery*; D010502:Perineum / Q000601:surgery; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000151:congenital / Q000601:surgery*