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Pediatric Surgery International
Published in: Pediatric Surgery International 4/2014

01-04-2014 | Original Article

Laparoscopic resection of adrenal neuroblastoma without image-defined risk factors: a prospective study on 21 consecutive pediatric patients

Authors: Girolamo Mattioli, Stefano Avanzini, Alessio Pini Prato, Luca Pio, Claudio Granata, Alberto Garaventa, Massimo Conte, Carla Manzitti, Giovanni Montobbio, Piero Buffa

Published in: Pediatric Surgery International | Issue 4/2014

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Abstract

Background

Over the last 20 years MIS has progressively gained popularity in children with cancer. We therefore aimed at evaluating the safety of Minimally Invasive Surgery (MIS) resection in a series of children affected by adrenal neuroblastoma (NB) presenting without Image-Defined Risk Factors (IDRFs).

Methods

An Institutional protocol for MIS resection of adrenal NB in pediatric patients without IDRFs has been applied since 2008. Absence of IDRFs represented the main indication for MIS in NB, regardless of tumor size. All pediatric patients who underwent MIS for NB between January 2008 and May 2013 were included. Specific technical considerations, demographic data, and outcome have been recorded.

Results

Twenty-one patients underwent MIS resection for IDRFs-negative adrenal NB. Nine of these patients experienced preoperative downgrading of IDRFs after chemotherapy. Radiological median diameter of the mass was 30 mm (range 10–83 mm). Median operative time was 90 min. Median hospital stay was 4 days. All patients were treated successfully, without serious intraoperative complications. One mild intraoperative hemorrhage occurred and was treated without the need for conversion to open surgery nor blood transfusion was required. No postoperative complications, including port-site or peritoneal metastases were experienced.

Conclusions

This study demonstrated the safety and effectiveness of MIS for the resection of adrenal NB without IDRFs in children. Pediatric surgeons dedicated to oncology should be aware of this alternative approach to open resection.
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Metadata
Title
Laparoscopic resection of adrenal neuroblastoma without image-defined risk factors: a prospective study on 21 consecutive pediatric patients
Authors
Girolamo Mattioli
Stefano Avanzini
Alessio Pini Prato
Luca Pio
Claudio Granata
Alberto Garaventa
Massimo Conte
Carla Manzitti
Giovanni Montobbio
Piero Buffa
Publication date
01-04-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 4/2014
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-014-3476-z

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