Sacrococcygeal teratoma in Sweden: a 10-year national retrospective study.

Thirty-two children with sacrococcygeal teratoma have been treated during the last 10 years (1980 to 1989) in Sweden. A retrospective study was performed in four departments of pediatric surgery that treat sacrococcygeal teratomas in children from the whole of Sweden. Prenatal and perinatal histories were reviewed together with interval to diagnosis, Altman classification, histology, and serum alpha-fetoprotein. Details of surgical management +/- adjuvant chemotherapy and outcome of patients were also documented. In 8 patients the teratoma was diagnosed prenatally by ultrasonography and there was one postoperative death in this group. Multiagent chemotherapy was used in all but one of 11 patients with malignant teratomas (in 8 of them a cisplatin, bleomycin, vinblastine combination). Only one patient with a malignant tumor treated by single-agent chemotherapy died, 8 others were still alive and tumor-free after 1 to 9 years (mean time, 5.4 years). Two patients developed late relapses and were treated by surgical resection. Metastases occurred in five of the 11 malignant tumors, one at presentation and in four patients 10 to 29 months following surgery. All relapses had distant metastases as well as local disease. Serum alpha-fetoprotein was used in monitoring some of these patients.

Oesophageal clamp anastomosis and stricture formation. An experimental study in the piglet.

End-to-end oesophageal anastomoses were performed with a metal clamp in 8 piglets. A transanastomotic catheter was kept in position for 5 weeks following release of the clamp. The results were evaluated by contrast radiography after a further 2 weeks. All the animals survived the operation and the pre-determined observation period. All the anastomoses healed without signs of leakage. They showed strictures of varying degrees, as assessed by radiography of the specimens. The dissected specimens showed scarred changes in the anastomoses where the thin mucosa was regenerated. The results are explained by the fact that the method of clamp anastomosis per se leads to a mucosal defect at the site of anastomosis with ensuing secondary wound healing. The intraluminal tube therby prevents wound contraction with luminal obliteration by giving the mucosa time to regenerate.

Relation of length of submucous segment of the ureter to lesions of the renal parenchyma in children.

The possible relationship between the length of the submucous ureteral segment and frequency and degree of renal parenchymal injury was analysed in children with urinary tract infection and vesico-ureteral reflux. If the grade of reflux was disregarded, no relation was found to exist between these parameters.