Minimally invasive surgery in pediatric cancer patients.
BACKGROUND
The specific use of minimally invasive surgery (MIS) in pediatric cancer patients is limited. We evaluated the 5-year experience at a single institution with MIS in children with malignancies.


METHODS
A retrospective review was undertaken of all MIS performed between November 1995 and October 2000.


RESULTS
A total of 101 pediatric oncology patients underwent 113 MIS procedures-64 laparoscopic (57%) and 49 thoracoscopic (43%)-during this period. Laparoscopy was performed for diagnostic purposes in 27 cases (42%) and was successful in 25 (93%) cases. Laparoscopic tumor resection was performed in seven cases (11%). Thirty additional laparoscopic procedures (47%) were attempted for complications of the malignancy or its treatment. Four of these cases were converted to open laparotomies. Indications for thoracoscopy included the evaluation of a mediastinal mass (n = 7) or biopsy or resection of pulmonary lesions (metastatic, n = 31; infectious, n = 9). Fourteen cases (29%) had to be converted to open thoracotomy procedures, generally because of the inability to localize a lesion. The other 35 procedures were successful. The overall complication rate was 5%. No trocar site recurrences or infections were observed.


CONCLUSIONS
We conclude that MIS in pediatric cancer patients is a safe and effective diagnostic modality. The role of MIS for primary tumor resection remains to be defined.
Spurbeck
William W
WW
Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. drspurbeck@yahoo.com
Davidoff
Andrew M
AM
Lobe
Thom E
TE
Rao
Bhaskar N
BN
Schropp
Kurt P
KP
Shochat
Stephen J
SJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007813:Laparotomy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009369:Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome