2024 Volume 60 Issue 2 Pages 276-282
We encountered three cases of giant sacrococcygeal teratoma diagnosed prenatally. One patient experienced cardiac arrest during tumor resection, presumably due to blood loss and hyperkalemia, and required cardiopulmonary resuscitation. In cases of giant sacrococcygeal teratoma, the mortality rate in neonates who undergo surgery within 24 hours after birth is as high as 24%, and careful management is required to prevent bleeding. Because rapid intravenous blood transfusion is required in the event of massive bleeding, securing an intravenous line with an appropriately large diameter is safer. Based on the experience of case 1, our hospital has made it our first choice to secure two 24G, and if possible, 22G peripheral venous lines in the upper limbs; if this is difficult, an external jugular vein cutdown method by a pediatric surgeon will be used. In cases 2 and 3, we were able to administer rapid intravenous blood transfusions. In addition, to adjust the appropriate transfusion dose without excess or deficiency, it is desirable to monitor circulatory control, other than intraoperative blood pressure and heart rate.
