Sacrococcygeal teratomas in children: optimization of the preoperative period and surgical treatment tactics

Aim - to determine the importance of postnatal diagnosis in the perinatal care of newborns, and older children with sacrococcygeal teratomas (SCT). Materials and methods. A retrospective analysis of medical records of 46 children with SCT who underwent surgical correction of the defect in the period 1981-2023 was performed. The main criteria for the tactics of preoperative preparation and surgical treatment of newborns and older children with SCT were studied. Results. A strategy for preoperative preparation of newborns with giant SCT, with a predominance of the cystic/solid component, was developed. A strategy for preoperative preparation of newborns with SCT complicated by profuse bleeding was developed. The timing of surgical intervention for different forms of SCT was determined. Surgical tactics for tumor resection were developed and improved. Conclusions. With a predominance of the cystic component of SCT, a series of decompression punctures of cysts is performed. In the presence of a giant SCT of mixed or solid structure - endovascular occlusion of the feeding vessels. In case of uncomplicated SCT, it is advisable to perform the operation at the beginning of the late neonatal period (8-10 days). In case of complicated SCT, emergency surgical intervention is performed immediately after birth. Circumferential access is the “gold standard” for resection of large and giant external components of SCT. Local devascularization of SCT is an important factor in preventing intraoperative bleeding. In case of moderate SCT, it is advisable to use sagittal skin grafting, V-shaped skin grafting - for large tumors, and plastic surgery using the “rotated Mercedes” technique - for giant SCT. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the local ethics committee of the institutions mentioned in the work. Parents' informed consent was obtained for children's participation in the study. The authors declare no conflict of interest.