Abstract
Background
: Laparoscopy may have a place in the management of malignancies, but its safety has been questioned. Few pediatric series have been reported. We present the combined experience of 11 centers on the place of laparoscopy in pediatric malignancies.
Methods
: A retrospective review of all laparoscopic evaluations for pediatric malignancies collected from 11 pediatric centers is reported.
Results
: In total, 51 patients underwent minimally invasive procedures. In 24 cases a presumed diagnosis of lymphoma was confirmed by biopsy. Twenty-seven solid tumors were found: 10 neuroblastomas, 5 hepatic tumors, 3 appendiceal carcinoids, 3 ovarian malignancies, and 6 miscellaneous tumors. Laparoscopic interventions included diagnostic biopsies in 37 (73%) cases, 9 complete resections, 2 oophorectomies, and 1 exploration. No port site metastases have been reported with a mean followup of 33.6 months. There were no perioperative mortalities.
Conclusions
: While it is one of the largest series on this topic, the relatively small number of cases suggests that laparoscopy plays a limited role in pediatric oncology. In addition to the safe resection of small lesions (including ovarian tumors), it is most useful for lymphoproliferative disorders and unresectable solid malignancies. This approach provides accurate diagnosis and allows assessment of tumor resectability. Tumor seeding at the port site does not appear to be a concern in pediatric malignancies.
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