Laparoscopy in the management of pediatric intraabdominal tumors.
OBJECTIVE
Unresectable intraabdominal tumors pose a challenge to the pediatric oncology team. Tumor tissue is needed for diagnostic and prognostic analyses. Laparotomy is quite invasive and computerized tomography-guided needle biopsies, though less invasive, may not procure enough tissue for a complete analysis. This study aimed to evaluate our experience with laparoscopy in managing these tumors.


METHODS
Nine children underwent laparoscopy: 6 for primary tumor biopsy, 2 for tumor resection, and 1 for tumor dissection followed by laparotomy for tumor resection.


RESULTS
The study included 7 females and 2 males with a median age of 5 years (range, 3 to 15 years). Three patients had neuroblastoma, 2 had mature ovarian teratomas, 2 had rhabdomyosarcoma, 1 had erythrophagocytic histiocytosis, and 1 had T-cell hepatosplenic lymphoma. In each case, adequate tissue was procured for diagnostic and prognostic analyses. No perioperative complications occurred. Both patients with ovarian teratomas are well. Four patients continue to receive anti-cancer therapy. The patient with erythrophagocytic histiocytosis underwent a cord-blood stem cell transplant. One patient with neuroblastoma was lost to follow-up, and 1 patient with rhabdomyosarcoma died of progressive disease.


CONCLUSIONS
Laparoscopy is a valuable technique in the management of pediatric intraabdominal tumors. It allows for tumor biopsy under direct vision, and adequate tissue is procured for all analyses. Moreover, it allows the surgeon to dissect the tumor and determine resectability.
Sandoval
Claudio
C
Department of Pediatrics, New York Medical College, Westchester Medical Center, Valhalla, New York 10595, USA.
Strom
Karl
K
Stringel
Gustavo
G
D000008:Abdominal Neoplasms / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D015614:Histiocytosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016399:Lymphoma, T-Cell / Q000473:pathology* / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000601:surgery; D012208:Rhabdomyosarcoma / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome