Surgical treatment for abdominal neuroblastoma in the laparoscopic era.
BACKGROUND
The role of laparoscopy in children with cancer has not been fully defined. The aims of this study were to develop an optimal surgical procedure for the treatment of abdominal neuroblastoma in the laparoscopic era and to evaluate the advantages and disadvantages of laparoscopy in the pediatric population.


METHODS
Since July 1997, 37 children were diagnosed with abdominal neuroblastoma at our center, and 44 surgical procedures were performed on them. Patients with advanced neuroblastoma underwent laparoscopic biopsy, open biopsy, and delayed primary or second-look excision, whereas early neuroblastoma cases had either laparoscopic or open excision. We compared the length of the operation, intraoperative blood loss, length of hospital stay, complications, and time to start postoperative feeding and chemotherapy for the laparoscopic and open surgery groups.


RESULTS
Length of stay and time to postoperative feeding and chemotherapy were significantly lower in the laparoscopic group than the open surgery group. However, there were no significant differences between the two groups in length of operation and intraoperative blood loss.


CONCLUSIONS
Laparoscopic biopsy and excision of abdominal neuroblastoma are effective and efficient surgical procedures in children.
Iwanaka
T
T
Departments of Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama 339-8551, Japan. a1080304@pref.saitama.jp
Arai
M
M
Ito
M
M
Kawashima
H
H
Yamamoto
K
K
Hanada
R
R
Imaizumi
S
S
D000008:Abdominal Neoplasms / Q000601:surgery*; D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009447:Neuroblastoma / Q000601:surgery*; D012186:Retroperitoneal Neoplasms / Q000601:surgery; D016896:Treatment Outcome