P0966 - Functional Fecal and Urinary Outcomes after Sacrococcygeal Tumor Resection in Pediatric Patients

Background: Sacrococcygeal masses are uncommon tumors in infants and children. The most common histopathology is mature sacrococcygeal teratoma (SCT), occurring in 1/40,000 births. These tumors are often challenging to approach given the proximity to and often displacement of pelvic functional organs, including bladder, rectum, and anal sphincter complex. The aim of this study is to describe functional bladder and bowel outcomes for patients who underwent resection of a sacrococcygeal mass.

Methods: A retrospective review was performed of patients who underwent sacrococcygeal mass resection between 1999 and 2019 and were followed long-term in surgical oncology and colorectal clinics at our institution. Baylor Social Continence Scale and Vancouver Symptom Score surveys were employed to assess fecal and urinary continence. Age at the time of the operation, tumor characteristics, histopathology, type of anorectal malformation (ARM) if present were also recorded. At each follow-up visit, bowel and urinary continence, and urinary tract infections were assessed.

Results: 74 patients were included in our study. 51 (69%) patients were females. 23 (31%) patients had an associated ARM. The median age at resection was 7 months [IQR 0-25]. 39 (53%) patients were clean for stool at most recent follow-up, 15 (20%) were diapered, and 4 (5%) were diverted. 28 (38%) were dry for urine, 18 (24%) on intermittent catheterizations, and 14 (19%) diapered. Post-operatively, 23 of the 58 patients over age 5 years (40%) formally attended a bowel management program. The mean Baylor continence scale was 15 and the Vancouver Symptom Score was 8 at most recent follow-up.

Conclusions: Sacrococcygeal masses are uncommon anomalies that may have long-term urinary and fecal functional outcomes. A multidisciplinary approach to the care of these complex patients with bowel and bladder management programs may optimize outcomes and patient quality of life.