Use of laparoscopic surgical resection for pediatric malignant solid tumors: a case series

Abstract

Minimally invasive surgery for malignant pediatric tumors remains controversial, and few cases have been published. The present study reports on our initial experiences of laparoscopic surgical resection for selected pediatric malignant solid tumors. We retrospectively analyzed data from ten pediatric patients who underwent laparoscopic surgical resection for malignant solid tumors at our institute between April 2005 and January 2010. There were four boys and six girls, including one neonate and four infants. The mean age at surgery was 23.3 months (range, 13 days-69 months). Six patients underwent laparoscopic adrenalectomy for neuroblastoma (n=5) or adrenocortical carcinoma (n=1). Two patients underwent laparoscopic partial hepatectomy for hepatoblastoma, one patient underwent a laparoscopic salpingo-oophorectomy for yolk sac tumor, and one a laparoscopic tumor excision for rhabdomyosarcoma in the pelvis. Complete tumor resection was performed in all cases. Tumors ranged from 2.5 to 5.3 cm maximum diameter. Tumors were placed inside endobags and removed safely without spillage. The mean operation time was 132 (range, 65-250) min. There were no open conversions and no postoperative complications. The mean postoperative hospital stay was 4.9 (range, 2-7) days, and all surgical wounds showed good cosmetic results. There were no local tumor recurrences during the 17.3-month median follow-up period. Laparoscopic surgical resection for selected pediatric malignant solid tumors was found to be feasible and safe. Long-term follow-up data are essential to confirm oncologic safety.