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- Patrizia Dall'igna (Italy)
- Ahmed Elgendy (Egypt)
Introduction
- Ahmed Elgendy (Egypt)
- Patrizia Dall'igna (Italy)
TREATMENT OF SACROCOCCYGEAL TERATOMA IN CHILDREN BY SINGLE INCISION OF SACROCOCCYGEAL REGION AND EVALUATION OF ANORECTAL FUNCTION AFTER OPERATION
- Zhonghai Guan (China)
Abstract
Background and Aims
Tumors of Altman type I and part of type II should be removed by sacrococcygeal incision according to traditional views, while abdominal sacrococcygeal incision should be considered for some cases of type II, III and IV with high presacral extension. Since 2015, sacrococcygeal single incision has been taken as the preferred route for all Altman types of sacrococcygeal teratomas in our hospital. The purpose of this study is to evaluate the feasibility and safety of this route in the treatment of all Altman types of sacrococcygeal teratomas.
Methods
from January 2015 to December 2018, children with sacrococcygeal teratoma treated by surgery in our hospital were analyzed, and the anorectal function of children in this cohort was followed up and evaluated. The recorded data included: age at admission, surgical approach, Altman classification and histopathological classification. The anorectal function was evaluated according to Li Zheng's score: defecation, purgation and incontinence.
Results
a total of 56 children were included in the study. Altman type was classified, and type I in 19 cases, type II in 26 cases, type III in 10 cases , and type IV in 1 case. All the 55 patients were operated by sacrococcygeal approach, and the tumor and tailbone were completely removed. Only one patient received abdominal sacrococcygeal operation because of the serious Inflammatory adhesion between the tumor and the pelvic. According to Li Zheng's anorectal function score method, 50 cases were good, 6 cases were moderate, 0 case was poor. The results showed that there was no significant difference in anorectal function scores among children of different ages, genders and pathological types, and different Altman types.
Conclusions
sacrococcygeal single incision is suitable for most children with sacrococcygeal teratoma, the anorectal function is satisfactory after operation, thus it can be considered as the first choice for children with sacrococcygeal teratoma.
THE EFFECT OF SURGICAL RESECTION AND FIRST-LINE CHEMOTHERAPY ON TREATMENT OUTCOME OF PEDIATRIC MALIGNANT MEDIASTINAL GERM CELL TUMORS: TAIWAN PEDIATRIC ONCOLOGY GROUP REPORT
- Ting-Huan Huang (Taiwan)
OUTCOMES OF BENIGN EXTRACRANIAL GERM CELL TUMORS – EXPERIENCES FROM A TERTIARY REFERRAL CENTRE IN INDIA
- Apoorv Singh (India)
INTRAOPERATIVE FINE NEEDLE ASPIRATION IN PEDIATRIC THYROID DISEASE: A NOVEL TECHNIQUE
- Zach Morrison (United States of America)
Abstract
Background and Aims
Fine needle aspiration (FNA) for thyroid nodules is not well-tolerated in children without sedation or anesthesia. Postoperative pathologic analysis may require a return to the operating room for completion thyroidectomy or nodal clearance. We present a novel technique in which FNA is completed in the operating room and hypothesize that it provides a sensitive, efficient, and safe approach to guide surgical resection that could avoid preoperative FNA or the need for reoperation.
Methods
Intraoperative FNA was completed by the surgeon at the time of thyroid lobectomy. The specimen was passed to the pathologist who completed microscopic evaluation with a mobile pathology cart in the operating room, providing results within minutes as the surgeon continued the dissection. This novel technique is reviewed retrospectively to determine the primary outcome of thyroid reoperation associated with the use of intraoperative FNA. All patients who underwent thyroid resection from 2016-2019 at our tertiary children’s hospital were considered. Secondary outcomes were the concordance rates between preoperative cytology, intraoperative cytology, and final surgical pathology and the proportion of patients whose preoperative FNA could have been replaced with an intraoperative FNA.
Results
Over three years, 47 patients underwent thyroid surgery. Seven patients underwent intraoperative FNA. Nineteen patients underwent preoperative FNA. Intraoperative cytology was concordant with final surgical pathology in six cases (85.7%). One patient (14.3%) required reoperation for intraoperative FNA under-diagnosis. Five patients underwent preoperative and intraoperative FNA biopsy of the same target; cytology was concordant in four of these cases (80.0%). Based on clinical presentation and preoperative imaging, 11 preoperative FNAs (57.9%) could have been avoided in favor of intraoperative FNA only.
Conclusions
Intraoperative FNA is a previously unreported strategy in the surgical management of pediatric thyroid disease. This sensitive, safe, and novel technique could save children from traumatic awake FNAs and prevent repeat exposure to anesthesia and subsequent operations.
LONG TERM COMPLICATIONS ASSOCIATED WITH THYROIDECTOMY IN CHILDREN WITH THYROID CANCER: EXPERIENCE IN AN ONCOLOGIC REFERRAL CENTER IN A DEVELOPING COUNTRY
- Juliana J. Mancera (Colombia)