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Minimally invasive surgical techniques are safe in the diagnosis and treatment of pediatric malignancies

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Abstract

Background

Minimally invasive surgical (MIS) techniques have become an established part of the care of the adult oncology patient. As surgeons have become more experienced with these advances in technique, MIS has recently seen an expanding role in the diagnosis and treatment of pediatric malignancies. We hypothesize that MIS techniques can be used to provide reliable diagnosis and safe therapeutic resection of many pediatric malignancies.

Procedure

We performed a retrospective review of all patients who underwent a minimally invasive operation for diagnosis or treatment of a malignant solid tumor at the Children’s Hospital Colorado over a ten-year period.

Results

A total of 105 minimally invasive procedures were performed in 98 patients, 61 % of which were male. The majority of cases, 78 (74 %) were thoracoscopic procedures and the remaining 27 (26 %) were laparoscopic procedures. Twenty-one (27 %) thoracoscopic procedures were performed for complete resection of primary tumor or metastases, with only three cases (14 %) converted to open thoracotomy. Tumors that were successfully removed thoracoscopically include neuroblastomas (n = 8), metastatic disease (n = 7), and a schwannoma. Of the 28 laparoscopic procedures, nine were performed for tumor resection with one case converted to open. Tumors that were successfully removed laparoscopically include 6 adrenal neuroblastomas and one pseudopapillary pancreatic tumor. There were no major surgical complications. No port site or surgical site recurrences were reported.

Conclusions

MIS techniques can be used safely and effectively for the diagnosis and resection of pediatric malignancies and treatment decisions can be made accurately based on tissue obtained.

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Disclosures

Drs. Acker, Bruny, Garrington, and Partrick have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Children’s Hospital Colorado, University of Colorado School of Medicine, 12631 E 17th Ave, C302, Aurora, CO, 80045, USA

    Shannon N. Acker, Jennifer L. Bruny & David A. Partrick

  2. Department of Pediatrics, Division of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, 80045, USA

    Timothy P. Garrington

Authors
  1. Shannon N. Acker
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  2. Jennifer L. Bruny
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  3. Timothy P. Garrington
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  4. David A. Partrick
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Correspondence to Shannon N. Acker.

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Acker, S.N., Bruny, J.L., Garrington, T.P. et al. Minimally invasive surgical techniques are safe in the diagnosis and treatment of pediatric malignancies. Surg Endosc 29, 1203–1208 (2015). https://doi.org/10.1007/s00464-014-3795-0

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  • DOI: https://doi.org/10.1007/s00464-014-3795-0

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