Safety and feasibility of laparoscopic resection of abdominal neuroblastoma without image-defined risk factors: a single-center experience

Abstract

Objective To explore the criteria, safety and efficacy of laparoscopic surgery in pediatric neuroblastoma (NB). Methods A retrospective study of 87 patients with NB without image-defined risk factors (IDRFs) between December 2016 and January 2021 at Beijing Children’s Hospital was conducted. Patients were divided into two groups according to the surgical procedure. Results Between the 87 patients, there were 54 (62.07%) cases in the open surgery group and 33 (37.93%) cases in the laparoscopic surgery group. There were no significant differences between the two groups regarding demographic characteristics, genomic and biological features, operating time or postoperative complications. However, in terms of intraoperative bleeding (p = 0.013) and the time to start postoperative feeding after surgery (p = 0.002), the laparoscopic group was obviously better than the open group. Furthermore, there was no significant difference in the prognosis between the two groups, and no recurrence or death was observed. Conclusion For children with localized NB who have no IDRFs, laparoscopic surgery could be performed safely and effectively. Surgeons who are skilled in this can help children reduce surgical injuries, speed up postoperative recovery, and obtain the same prognosis as open surgery.

The role of Pediatric Surgery in childhood cancer

“…This minimally invasive approach facilitates complex procedures, leading to reduced blood loss, improved cosmetic outcomes, and potentially better surgical margins. The use of robotic surgery in the resection of pediatric solid tumors has shown promising results in terms of patient recovery and postoperative quality of life 19 . Despite its advantages, the integration of robotic surgery faces significant challenges, notably the high costs of equipment and the specialized training required for surgeons.…”

“…These challenges are particularly acute in low- and middle-income countries (LMICs), where limited resources and access to training can impede the widespread adoption of robotic surgery. Additionally, the learning curve associated with these techniques necessitates ongoing education and skill development among surgical teams 13 , 15 , 19 .…”

Risk factors, impact and treatment of postoperative lymphatic leakage in children with abdominal neuroblastoma operated on by laparotomy

“…In open surgery, we routinely place a retroperitoneal drainage tube at the end of the operation. According to our experience, laparoscopic surgery could be considered if the localized tumor was confined to one body compartment and did not involve the list of IDRFs [ 19 ]. And if the localized tumor did not invade the surrounding tissue and no more than 2 lymphatic regions were resected, the drainage tube was generally not considered in laparoscopic surgery.…”