Sacrococcygeal Teratoma

Published on 27/02/2015 by admin

Filed under Pediatrics

Last modified 22/04/2025

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CHAPTER 35 Sacrococcygeal Teratoma

Step 2: Preoperative Considerations

Infant and Pediatric Patients

Table 35-1 Frequency of Malignancy Associated with Higher American Academy of Pediatrics Anatomic Classification

AAP TYPE MALIGNANT (%) METASTASIS (%)
I 8 0
II 21 6
III 34 20
IV 38 8

Step 3: Operative Steps

Positioning

About 46.7% of SCTs have a significant external component (AAP class I) and can generally be approached in a prone jack-knife position.1 This can be accomplished using a gel roll to support the face and head in neutral position, along with a thoracic gel roll, with the arms in a swimmer’s position. The pelvis is generously elevated using additional gel rolls under the anterior superior iliac spine, with the hips flexed and abducted and the knees slightly flexed and the feet supported with a soft roll (Fig. 35-4).

Posterior Perineal Approach

In a prone jack-knife position, an inverted “V” or inverted chevron incision is made with the apex focused on the sacrococcygeal joint (Fig. 35-6). The incision sweeps inferolaterally around the tumor to encompass the mass and abnormal or ischemic skin.