Minimally invasive surgery versus open surgery for the treatment of solid abdominal and thoracic neoplasms in children.
BACKGROUND
Minimally invasive surgery (MIS) is an accepted surgical technique for the treatment of a variety of benign diseases. Presently, the use of MIS in patients with cancer is progressing. However, the role of MIS in children with solid neoplasms is less clear than it is in adults. Diagnostic MIS to obtain biopsy specimens for pathology has been accepted as a technique in paediatric surgical oncology, but there is limited experience with the use of MIS for the resection of malignancies.


OBJECTIVE
To ascertain the differences in outcome between the minimally invasive and open approach in the treatment of solid intra-thoracic and intra-abdominal neoplasms in children, regarding overall survival, event-free survival, port-site metastases, recurrence rate and surgical morbidity.


METHODS
We searched the electronic databases of MEDLINE/PubMed (from 1966 to March 2008), EMBASE/Ovid (from 1980 to March 2008) and CENTRAL (The Cochrane Library 2008, Issue 1) with pre-specified terms. In addition, we searched reference lists of relevant articles and reviews, conference proceedings and ongoing trial databases.


METHODS
Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) comparing MIS and open surgery for the treatment of solid intra-thoracic or intra-abdominal neoplasms in children (aged 0 to 18 years).


METHODS
Two authors performed the study selection independently.


RESULTS
No studies that met the inclusion criteria of this review were identified.


CONCLUSIONS
No RCTs or CCTs evaluating MIS in the treatment of solid intra-thoracic or intra-abdominal neoplasms in children could be identified, therefore no definitive conclusions could be made about the effects of MIS in these patients. Based on the currently available evidence we are not able to give recommendations for the use of MIS in the treatment of solid intra-thoracic or intra-abdominal neoplasms in children. More high quality studies (RCTs and/or CCTs) are needed. To accomplish this, centres specialising in MIS in children should collaborate.
Radiology, Academic Medical Center, PO Box 22660, Amsterdam, Netherlands, 1100 DD.
Manou S
MS
de Lijster
Rosemarijn M
RM
Bergevoet
Elvira C
EC
van Dalen
Erna Mc
EM
Michiels
Huib N
HN
Caron
Leontien Cm
LC
Kremer
Daniel C
DC
Aronson
D000008:Abdominal Neoplasms / Q000601:surgery*; D002648:Child; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D013899:Thoracic Neoplasms / Q000601:surgery*