title: Minimally invasive surgery and clinical decision-making for pediatric malignancy.
abstract: BACKGROUND
  Minimally invasive surgery (MIS) is an ideal way to obtain biopsy specimens in children with cancer. We examined the safety, reliability and outcome of decisions made based on tissue obtained using MIS.
  
  
  METHODS
  Fifty-nine oncology patients underwent 62 MIS procedures between January 1994 and July 1998. Complications, biopsy results, and outcomes were reviewed.
  
  
  RESULTS
  The study population comprised 32 boys and 27 girls, with an average age of 8.8 years. There were 47 thoracoscopic and 15 laparoscopic operations. Laparoscopic procedures included initial biopsy, determination of resectability, and second-look exam. Thoracoscopic procedures included 40 lung biopsies and seven biopsies/resections of mediastinal masses. Diagnostic accuracy was 100% in all cases. No patient was found retrospectively to have been inadequately treated based on decisions made from tissue obtained by MIS.
  
  
  CONCLUSIONS
  MIS is a safe and accurate means of obtaining tissue in pediatric oncology patients. Treatment decisions can be made accurately and with confidence using these techniques.
authors.affiliation: Department of Surgery, Children's Hospital and Regional Medical Center University of Washington School of Medicine, Seattle 98105, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Waldhausen
authors.forename: D
authors.initials: D
authors.lastname: Tapper
authors.forename: R S
authors.initials: RS
authors.lastname: Sawin
mesh_terms: D000008:Abdominal Neoplasms / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D001706:Biopsy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000473:pathology / Q000601:surgery*; D013906:Thoracoscopy