[The role of minimally invasive surgery in the diagnosis and treatment of tumors in children].
The paper aims to define the actual place and benefits of the minimal invasive techniques in the diagnosis and treatment of tumors in children. There are reviewed the indications, limits and complications of this method in digestive tract, liver, pancreatic, adnexal, testicular and renal tumors, in lymphomas, as well as in tumors with intra-thoracic location. The benefits of the minimal access approach, such as the decrease of the parietal complications as well as the negative impact of the surgical act upon the body have a particular significance in pediatric cancer patients. Their quicker recovery allows an early subsequent initiation of the chemo- or/and radiotherapy. Within the complex treatment of tumors in children, the minimal invasive surgery has a diagnostic value through inspection and directed biopsy. The laparoscopic inspection decreases the number of non-therapeutic laparotomies in non-operable patients with tumors that were not preoperatively diagnosed using imaging methods. The laparoscopic resection of the tumors within oncological limits is possible in the localized types (stage I). As a particular aspect of the laparoscopic approach in children, it is worth mentioning the difficulties related to the necessity of using adequate-size instruments and to the less favorable relation between the size of the tumor and the diminished working space.
Ionescu
S
S
Clinica de Chirurgie Pediatrică, Spitalul Clinic de Urgenţă pentru Copii Maria Sklodowska Curie, Bucureşti. nsionescu@yahoo.com
Andrei
B
B
Filip
S
S
Nicoară
D C
DC
D002648:Child; D004067:Digestive System Neoplasms / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000601:surgery; D005834:Genital Neoplasms, Male / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome; D014565:Urogenital Neoplasms / Q000175:diagnosis / Q000601:surgery; D014571:Urologic Neoplasms / Q000175:diagnosis / Q000601:surgery