Endosurgical procedures for pediatric solid tumors

Byline: Tadashi Iwanaka (1), Mari Arai (1), Hiroshi Kawashima (1), Sumi Kudou (1), Jun Fujishiro (1), Satohiko Imaizumi (1), Keiko Yamamoto (1), Ryouji Hanada (1), Akira Kikuchi (1), Toshinori Aihara (1), Hiroshi Kishimoto (1) Keywords: Neuroblastoma; Ovarian tumor; Laparoscopy; Thoracoscopy; Children Abstract: The aim of this study was to evaluate the advantages and complications of endosurgical procedures for benign and malignant pediatric solid tumors. Endosurgical techniques of biopsy and excision were used for diagnosis and treatment of solid tumors, respectively. Since July 1997, a total of 24 biopsies and 24 excisions have been performed laparoscopically for neuroblastoma (n=24), ovarian solid tumors (n=10) and other tumors. Seventeen biopsies and six excisions were performed for abdominal neuroblastoma, while ten excisions were performed for ovarian tumor. In these patients, the length of the operation, blood loss, time to start postoperative feeding, time to start postoperative chemotherapy and length of hospital stay were evaluated and compared to the those of the open surgery group. Furthermore, intra- and postoperative complications were analyzed in all patients of both groups. The length of the hospital stay and time to start postoperative feeding were significantly shorter in the group of patients who underwent endosurgical procedures for either abdominal neuroblastoma or ovarian tumor when compared to the open procedure group. The time to start postoperative chemotherapy was shorter only in the abdominal neuroblastoma group. The procedure for two patients undergoing endosurgical tumor excision had to be converted to open surgery due to large tumor size. Two weeks after thoracoscopic excision of a dumb bell-type neurofibroma, one patient underwent open repair of the dura mater because of leakage of cerebrospinal fluid. There were no port-site recurrences in any tumor types. Endosurgical procedures for solid tumors are effective and minimally invasive. However, better indicators are needed for their implementation in order to prevent complications and subsequent conversions to open procedures. Author Affiliation: (1) Saitama Children's Medical Center, 2100 Magome, Iwatsuki, 339-8551, Saitama, Japan Article History: Registration Date: 01/01/2003 Online Date: 20/12/2003