title: Minimally invasive surgical techniques are safe in the diagnosis and treatment of pediatric malignancies.
abstract: BACKGROUND
  Minimally invasive surgical (MIS) techniques have become an established part of the care of the adult oncology patient. As surgeons have become more experienced with these advances in technique, MIS has recently seen an expanding role in the diagnosis and treatment of pediatric malignancies. We hypothesize that MIS techniques can be used to provide reliable diagnosis and safe therapeutic resection of many pediatric malignancies.
  
  
  METHODS
  We performed a retrospective review of all patients who underwent a minimally invasive operation for diagnosis or treatment of a malignant solid tumor at the Children's Hospital Colorado over a ten-year period.
  
  
  RESULTS
  A total of 105 minimally invasive procedures were performed in 98 patients, 61% of which were male. The majority of cases, 78 (74%) were thoracoscopic procedures and the remaining 27 (26%) were laparoscopic procedures. Twenty-one (27%) thoracoscopic procedures were performed for complete resection of primary tumor or metastases, with only three cases (14%) converted to open thoracotomy. Tumors that were successfully removed thoracoscopically include neuroblastomas (n = 8), metastatic disease (n = 7), and a schwannoma. Of the 28 laparoscopic procedures, nine were performed for tumor resection with one case converted to open. Tumors that were successfully removed laparoscopically include 6 adrenal neuroblastomas and one pseudopapillary pancreatic tumor. There were no major surgical complications. No port site or surgical site recurrences were reported.
  
  
  CONCLUSIONS
  MIS techniques can be used safely and effectively for the diagnosis and resection of pediatric malignancies and treatment decisions can be made accurately based on tissue obtained.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, 12631 E 17th Ave, C302, Aurora, CO, 80045, USA, shannon.acker@ucdenver.edu.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Acker
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bruny
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Garrington
authors.forename: David A
authors.initials: DA
authors.lastname: Partrick
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008223:Lymphoma / Q000601:surgery; D008297:Male; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D009442:Neurilemmoma / Q000601:surgery; D009447:Neuroblastoma / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods