Surgical intervention and perioperative risk factors of retroperitoneal teratomas in children: a single institution experience

Shigehisa Fumino, Junnosuke Maniwa, Yuki Takeuchi, Kohei Sakai, Mayumi Higashi, Shigeyoshi Aoi, Taizo Furukawa, Osamu Kimura, Tatsuro Tajiri

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Retroperitoneal teratomas (RTs) are rare among germ cell tumors and predominantly occur in infants. RTs are often difficult to manage by perioperative management. In this study, we retrospectively reviewed our series of RTs. Methods: Seventy patients with germ cell tumors were treated from 1989 to 2015 in our institution. Fourteen patients had RTs (3 boys and 11 girls). The median age at diagnosis was 5.5 months (range 0–64), and three were antenatally diagnosed. Results: All except one patient underwent total tumor excision. They exhibited dense adhesions with major vessels, and ligation of the splenic and gastroduodenal arteries was required in two patients. Injuries of PV and renal artery occurred in two patients. IVC injury in a neonate with a giant mass caused circulatory failure and brain death occurred postoperatively. Other major complications included injury of the diaphragm and bile duct. An infant whose tumor compressed the superior mesenteric artery developed enteritis while waiting for surgery and non-occlusive mesenteric ischemia, resulting in massive intestinal necrosis. The perioperative complication rate was 50 %. Conclusion: Surgery for RTs remains challenging, and a preoperative evaluation of the vascular anatomy is crucial due to the high complication rate. Moreover, pre- and intraoperative fluid management is important to avoid any unexpected fatalities.

Original languageEnglish
Pages (from-to)909-914
Number of pages6
JournalPediatric surgery international
Volume32
Issue number9
DOIs
Publication statusPublished - Sep 1 2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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