本文通过回顾性分析1例47岁女性巨大骶前畸胎瘤合并慢性感染及多发皮肤窦道患者的临床资料，探讨经骶尾入路切除巨大骶前畸胎瘤并一期应用生物补片行盆底重建的可行性及安全性。术前经多学科讨论评估手术入路，采用经骶尾入路将肿瘤及感染窦道整块切除，同期以猪小肠黏膜下层（SIS）生物补片包裹膨出的直肠后壁行盆底重建。肿瘤被完整切除，经病理证实为成熟性畸胎瘤。术后切口甲级愈合，未发生血清肿、补片感染及切口延迟愈合。术后随访6个月，无感染复发及会阴疝发生，Wexner便秘评分为1分。提示对于合并慢性感染及皮肤窦道的巨大骶前畸胎瘤，经骶尾入路可同时实现肿瘤根治与感染控制，一期SIS生物补片盆底重建安全可行。

This study retrospectively analyzed the clinical data of a 47-year-old woman with a giant presacral teratoma complicated by chronic infection and multiple cutaneous sinus tracts, to evaluate the feasibility and safety of transsacrococcygeal resection combined with single-stage pelvic floor reconstruction using a biologic mesh. Following a preoperative multidisciplinary discussion to assess the surgical approach, the tumor and associated infected sinus tracts were resected en bloc via a transsacrococcygeal approach. During the same operation, pelvic floor reconstruction was performed using a porcine small intestinal submucosa (SIS) biologic mesh to wrap and support the bulging posterior rectal wall. The tumor was completely excised, and histopathological examination confirmed a mature teratoma. The incision healed by primary intention, with no seroma, mesh infection, or delayed wound healing. At the 6-month postoperative follow-up, no recurrent infection or perineal hernia was observed, and the Wexner constipation score was 1. This case suggests that, in selected patients with giant presacral teratomas complicated by chronic infection and cutaneous sinus tracts, the transsacrococcygeal approach may enable complete tumor resection and infection control, while single-stage pelvic floor reconstruction using an SIS biologic mesh may be feasible and safe in the short term.