title: Contraindications and image-defined risk factors in laparoscopic resection of abdominal neuroblastoma.
abstract: OBJECTIVE
  Minimally invasive surgery (MIS) has become widely accepted as a technique for abdominal neuroblastoma resection. However, the indications for MIS are still controversial. The aim of this study was to evaluate image-defined risk factors (IDRFs), complications, and oncologic outcomes in patients with abdominal neuroblastomas treated with MIS.
  
  
  METHODS
  Between August 1998 and February 2016, MIS was planned for 20 children with abdominal neuroblastomas. Clinical data were retrospectively reviewed and compared between the IDRF-negative and IDRF-positive patients.
  
  
  RESULTS
  On the basis of the latest IDRF guidelines, five patients were classified as IDRF-positive and four of them had operative complications; namely, partial infarction of the ipsilateral kidney or open conversion. Concerning the two patients who needed open conversion, the primary reason for open conversion was difficulty in dissection of the tumor from the vena cava. Preoperative images of these cases showed either deformation or subtotal encasement of the vena cava. Relapse occurred in three high-risk patients and in none of the low/intermediate-risk patients. No complication occurred in the IDRF-negative cases.
  
  
  CONCLUSIONS
  IDRF-negative might be a good indication for MIS for abdominal neuroblastoma. However, deformation or subtotal encasement of the vena cava should be considered as IDRF-positive for MIS.
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan. ytanaka-tky@umin.ac.jp.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashima
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, 339-8551, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Michimasa
authors.initials: M
authors.lastname: Fujiogi
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Hizuru
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Morita
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, 339-8551, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, 339-8551, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Koh
authors.affiliation: Department of Radiology, Saitama Children's Medical Center, Saitama, 339-8551, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Oguma
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002675:Child, Preschool; D000075202:Contraindications; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007238:Infarction; D007668:Kidney / Q000098:blood supply; D010535:Laparoscopy; D008297:Male; D009361:Neoplasm Invasiveness; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014684:Venae Cavae / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: IDRF; Laparoscopy; Neuroblastoma; Vena cava