title: Atypical laparoscopic resection of a liver tumor in a 4-year-old girl.
abstract: Despite the advances in minimally invasive surgery in children, considerable concern exists about employing such techniques in oncologic cases. We report our experience with a 4-year-old girl with a symptomatic tumor in the liver. Contrast-enhanced computed tomography revealed a 3 x 4 cm lesion, confined to segments II and III. Tumor markers were negative and true-cut needle biopsy did not rule out malignancy. We performed a diagnostic laparoscopy using four 5-mm ports. Since the tumor did not cause any alterations of the liver surface, a 5-mm flexible endoscopic ultrasound probe (5 MHz) was applied to reveal the extent of the tumor. Parenchymal dissection was performed with a radiofrequency probe, and the LigaSure device was used to seal larger vessels and bile ducts. The tumor was resected completely and removed in a specimen bag via the umbilical incision. Histology revealed fibrous nodular hyperplasia. The postoperative course was uneventful and the girl was discharged on postoperative day 5. We conclude that laparoscopic resection of confined liver lesions is feasible in children, employing standard principles of oncologic surgery and safety.
authors.affiliation: Division of Pediatric Surgery and Pediatric Urology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. ckyeung@surgery.cuhk.edu.hk
authors.forename: Chung Kwong
authors.initials: CK
authors.lastname: Yeung
authors.forename: Sujit Kumar
authors.initials: SK
authors.lastname: Chowdhary
authors.forename: Kin Wai
authors.initials: KW
authors.lastname: Chan
authors.forename: Kim Hung
authors.initials: KH
authors.lastname: Lee
authors.forename: Holger
authors.initials: H
authors.lastname: Till
mesh_terms: D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media