Abstract
Sacrococcygeal teratomas originate from the embryonic germ cell layers and are the most common neonatal tumor. The tumor is usually benign and has solid and cystic structures, but may be prone to bleeding due to increased vascularization. The anesthesia management of these cases is challenging due to the risk of bleeding, hemodynamic instability, electrolyte imbalance, hypothermia, and acidosis. Complications may cause serious perioperative morbidity and mortality. In this case report, important steps in the anesthesia management of a female patient, who was born at 29 weeks and 6 days of gestation, weighed 2190 g, and was operated for a mass compatible with sacrococcygeal teratoma on the 3rd day of her life were emphasized. The importance of preoperative preparation, invasive arterial monitoring, close follow-up of blood, fluid and electrolyte replacement is presented in the light of the literature.
References
- Flake AW. Fetal Sacrococcygeal Teratoma. Semin Pediatr Surg 1993;2:113-20.
- Herman TE, Siegel MJ. Cystic Type IV Sacrococcygeal Teratoma. J Perinatol 2002;22:331-2.
- Makin EC, Hyett J, Ade-Ajayi N, Patel S, Nicolaides K, Davenport M. Outcome of antenatally diagnosed sacrococcygeal teratomas: Single-center experience (1993- 2004). J Pediatr Surg 2006;41:388-93.
- Altman RP, Randolph JG, Lilly JR. Sacrococcygeal Teratoma: American Academy of Pediatrics Surgical Section Survey-1973. J Pediatr Surg 1974; 9: 389-98.
- Tekin N, Soylu H ve Dilli D. Türk Neonatoloji Derneği Yenidoğanın Hemodinamisi ve Yenidoğanlarda Hipotansiyona Yaklaşım Rehberi. 2017. http://www.neonatology.org.tr/wp-content/uploads/2016/12/neonatal-hemodinami-rehberi2017.pdf
- Abraham E, Parray T, Ghafoor A. Complications with massive sacroccygeal tumor resection on a premature neonate.J Anesth 2010;951-954.
- Kim JW, Gwak M, Park JY,Kim HJ, Lee YM.Cardiac arrest during excision of a huge sacrococcygeal teratoma-A report of two cases. Korean J Anesthesiol 2012;80-4.
- İnce Z,Yapıcıoğlu Yıldızdaş H, Demirel N. Yenidoğanda Sıvı ve Elektrolit Dengesi Rehberi,2021 Güncellemesi, , https://www.turkarchpediatr.org/Content/files/sayilar/35/TPA-24540-YAPICIOGLU_YILDIZDAS(1).pdf,15.03.2022
- Kremer ME, Wellens LM, DerikxJP, van Baren R. Heij HA, Wijnen MHWA, et al. Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma. J Pediatr Surg 2016;1826-9.
- Gümüş Özcan F, Erol M, Güneyli HC, Demirgan S, Yavuz MB, Toksoy N et al. Anesthetic Management in Prematüre Newborn with Huge Sacrococcygeal Teratoma. A Case Report. Bagcilar Med Bull 2020;5:144-7.
- Çetinkaya M, Atasay B, Perk Y. Turkish Neonatal Society guideline on the transfusion principles in newborns. Turk Pediatri Ars 2018; 53 (Suppl 1): S101-S108.
- Prematüre ve Hasta Term Bebeğin Beslenmesi Rehberi, 2018 Güncellemesi,https://www.neonatology.org.tr/wpcontent/uploads/2020/04/premature_rehber_2018.pdf,15.04.2022
- Türk Anesteziyoloji ve Reaminasyon Derneği, İstenmeyen perioperatif hipoterminin önlenmesi rehberi, anestezi uygulama kılavuzları, 2013;https://www.tard.org.tr/assets/kilavuz/yeni.pdf,21.04.2022
- Pearce B, Christensen R, Voepel-Lewis T. Perioperative hypothermia in the pediatric population: prevalence, risk factors and outcomes. J Anesthe Clinic Res 2010;1:102.
Abstract
Sakrokoksigeal teratomlar embriyojenik germ hücre katmanlarından köken alan, yenidoğanın en sık görülen tümörüdür. Genellikle iyi huylu olan tümör solid ve kistik yapıya ek olarak vaskülarizasyondaki artış nedeniyle kanamaya eğilimli olabilir. Bu olguların kanama riski, hemodinamik instabilite, elektrolit imbalansı, hipotermi, asidoz riski nedeniyle anestezi yönetimi özelliklidir. Gelişen komplikasyonlar perioperatif ciddi morbidite ve mortaliteye sebep olabilir. Bu olgu sunumunda postnatal 3. gününde opere edilen, 29 hafta 6 günlük, 2190 gr ağırlığında sakrokoksigeal teratomla uyumlu kitlesi olan kız hastanın anestezi yönetimindeki önemli adımlar vurgulanmıştır. Preoperatif hazırlık, invaziv arter monitorizasyonu, kan, sıvı ve elektrolit replasmanının yakın takibinin önemi literatür eşliğinde sunulmuştur.
References
- Flake AW. Fetal Sacrococcygeal Teratoma. Semin Pediatr Surg 1993;2:113-20.
- Herman TE, Siegel MJ. Cystic Type IV Sacrococcygeal Teratoma. J Perinatol 2002;22:331-2.
- Makin EC, Hyett J, Ade-Ajayi N, Patel S, Nicolaides K, Davenport M. Outcome of antenatally diagnosed sacrococcygeal teratomas: Single-center experience (1993- 2004). J Pediatr Surg 2006;41:388-93.
- Altman RP, Randolph JG, Lilly JR. Sacrococcygeal Teratoma: American Academy of Pediatrics Surgical Section Survey-1973. J Pediatr Surg 1974; 9: 389-98.
- Tekin N, Soylu H ve Dilli D. Türk Neonatoloji Derneği Yenidoğanın Hemodinamisi ve Yenidoğanlarda Hipotansiyona Yaklaşım Rehberi. 2017. http://www.neonatology.org.tr/wp-content/uploads/2016/12/neonatal-hemodinami-rehberi2017.pdf
- Abraham E, Parray T, Ghafoor A. Complications with massive sacroccygeal tumor resection on a premature neonate.J Anesth 2010;951-954.
- Kim JW, Gwak M, Park JY,Kim HJ, Lee YM.Cardiac arrest during excision of a huge sacrococcygeal teratoma-A report of two cases. Korean J Anesthesiol 2012;80-4.
- İnce Z,Yapıcıoğlu Yıldızdaş H, Demirel N. Yenidoğanda Sıvı ve Elektrolit Dengesi Rehberi,2021 Güncellemesi, , https://www.turkarchpediatr.org/Content/files/sayilar/35/TPA-24540-YAPICIOGLU_YILDIZDAS(1).pdf,15.03.2022
- Kremer ME, Wellens LM, DerikxJP, van Baren R. Heij HA, Wijnen MHWA, et al. Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma. J Pediatr Surg 2016;1826-9.
- Gümüş Özcan F, Erol M, Güneyli HC, Demirgan S, Yavuz MB, Toksoy N et al. Anesthetic Management in Prematüre Newborn with Huge Sacrococcygeal Teratoma. A Case Report. Bagcilar Med Bull 2020;5:144-7.
- Çetinkaya M, Atasay B, Perk Y. Turkish Neonatal Society guideline on the transfusion principles in newborns. Turk Pediatri Ars 2018; 53 (Suppl 1): S101-S108.
- Prematüre ve Hasta Term Bebeğin Beslenmesi Rehberi, 2018 Güncellemesi,https://www.neonatology.org.tr/wpcontent/uploads/2020/04/premature_rehber_2018.pdf,15.04.2022
- Türk Anesteziyoloji ve Reaminasyon Derneği, İstenmeyen perioperatif hipoterminin önlenmesi rehberi, anestezi uygulama kılavuzları, 2013;https://www.tard.org.tr/assets/kilavuz/yeni.pdf,21.04.2022
- Pearce B, Christensen R, Voepel-Lewis T. Perioperative hypothermia in the pediatric population: prevalence, risk factors and outcomes. J Anesthe Clinic Res 2010;1:102.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | CASE REPORTS |
| Authors | |
| Publication Date | November 30, 2022 |
| Submission Date | April 27, 2022 |
| Published in Issue | Year 2022 Volume: 16 Issue: 6 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.