Extirpation of mass-screened adrenal neuroblastomas by retroperitoneoscopy.
BACKGROUND
A mass-screened neuroblastoma (MSN) shows low-grade malignancy. Although the tumor is small, open laparotomy requires a large incision.


OBJECTIVE
Extirpation by retroperitoneoscopy (ER) was performed in children with MSN to reduce the surgical stress.


METHODS
The indications for ER were (1) MSN originating from the adrenal gland and (2) a tumor size of less than 4 cm. Between January 2000 and June 2002, 6 children (mean age: 8.5 +/- 0.6 months) underwent ER.


RESULTS
All children successfully underwent ER and no conversion of laparoscopy to open surgery was required. The only complication in one patient was a peritoneal tear. Oral intake was possible in all children the day after the operation. No port site metastasis or local recurrence was observed during follow-up (15 to 29 months).


CONCLUSIONS
Adrenal MSN less than 4 cm were successfully extirpated by ER. This method has the advantage of allowing patients an early return to eating and has no risk of postoperative ileus. ER is an available surgical technique for children with MSN less than 4 cm.
Kouch
K
K
Department of Pediatric Surgery, School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba, 260-8677, Japan. kouchi@ho.chiba-u.ac.jp
Yoshida
H
H
Matsunaga
T
T
Ohtsuka
Y
Y
Okada
T
T
Saito
T
T
Matsuura
G
G
Yamada
H
H
Ohnuma
N
N
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008403:Mass Screening; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016896:Treatment Outcome