Laparoscopic Adrenalectomy in Children: A Multicenter Experience

Abstract

The laparoscopic approach can be applied for adrenalectomy in children for a wide variety of conditions regardless of age with a 90% chance of completing the operation without conversion. The risk for significant blood loss or complications is low, and it should be considered the preferred approach for the majority of adrenal lesions in children.

Mini-Invasive Surgery for Adrenocortical Carcinoma in Children: Is It Safe?

“…International Pediatric Endosurgery Group guidelines [5] states that LA is technically feasible in children and can be performed in selected patients for benign and malignant tumors. Indeed, in large reviews [1,6], safety of LA has been demonstrated with a low conversion rate. In 2004, Porpiglia et al [7] reported that LA was a feasible option for ACC, if the principles of oncological surgery are respected.…”

“…Adrenalectomy by minimal invasive surgery is used worldwide since the 1990s but experience in children remains limited. However, in a large multicentric study [1], it has been showed that LA can be used regardless of age and should be considered as the preferred approach for the majority of adrenal lesions in children.…”

A expressão dos marcadores de células-tronco, SF1 e DAX1 no desenvolvimento do córtex adrenal humano e sua associação com a via Wnt/beta-catenina na tumorigênese adrenocortical

“…Porém, foi observado que este sistema apresentava uma falha na separação prognóstica entre os estágios II e III (65). Posteriormente, o grupo europeu (ENSAT) propôs um novo sistema de estadiamento (Tabela 2) que tem sido recomendado para a padronização na estratificação prognóstica de pacientes adultos.…”

“…Pacientes em que o tumor foi diagnosticado e tratado ainda no estágio I apresentam cerca de 82% de sobrevida após cinco anos de segmento, enquanto em pacientes diagnosticados já em estágio IV, a sobrevida em cinco anos é de cerca de 18% (65).…”

“…Therefore, laparotomy is still the most recommended surgical approach [27,63,64]. Despite this, based on the advantages of laparoscopy over open surgery (shorter hospital stay, faster postoperative recovery and better cosmetic results), some services with experience in laparoscopy surgery have reported good results with this technique in pediatric ACTs [65][66][67]. The literature regarding laparoscopic outcomes in pediatric ACTs remains scarce and results seem to be limited to personal experience.…”