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腹腔镜下腹膜后神经母细胞瘤切除术的可行性和安全性。

Feasibility and safety of laparoscopic tumor resection in children with abdominal neuroblastomas.

机构信息

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, 840 Murodo-Cho, Izumi, Osaka, 594-1101, Japan.

出版信息

Pediatr Surg Int. 2023 Jan 25;39(1):91. doi: 10.1007/s00383-023-05371-8.

Abstract

PURPOSE

This study aimed to evaluate the feasibility and safety of laparoscopic resection of abdominal neuroblastoma by comparing operative and long-term oncologic outcomes between open and laparoscopic surgeries.

METHODS

This single-center retrospective study included patients who underwent laparoscopic tumor resection, between January 2000 and June 2021, with a maximum tumor diameter of ≤ 60 mm and without image-defined risk factors (IDRFs) at surgery. Data from 35 abdominal neuroblastoma resections were reviewed and compared between the laparotomy and laparoscopic groups.

RESULTS

Nineteen patients underwent laparotomy and 16 had laparoscopic tumor resection. All laparoscopic surgeries achieved complete resection without conversion to open surgery. Median blood loss was significantly lower in the laparoscopic group (0.6 mL/kg) than in the laparotomy group (8.4 mL/kg) (P < 0.0001). There were two locoregional recurrences in the laparoscopic group and two metastatic recurrences in the laparotomy group. Five-year overall survival was 93.8% in both groups.

CONCLUSION

Laparoscopic resection of abdominal neuroblastomas in children is a feasible and safe procedure for tumors ≤ 60 mm in diameter with no IDRFs at surgery, with long-term outcomes equivalent to laparotomy.

摘要

目的

本研究旨在通过比较开放手术和腹腔镜手术的手术和长期肿瘤学结果,评估腹腔镜切除腹部神经母细胞瘤的可行性和安全性。

方法

本单中心回顾性研究纳入了 2000 年 1 月至 2021 年 6 月期间接受腹腔镜肿瘤切除术的患者,最大肿瘤直径≤60mm,且手术时无影像学定义的危险因素(IDRFs)。回顾并比较了剖腹手术和腹腔镜手术组的 35 例腹部神经母细胞瘤切除术的数据。

结果

19 例患者接受剖腹手术,16 例患者接受腹腔镜肿瘤切除术。所有腹腔镜手术均成功完成,无需转为开放手术。腹腔镜组的中位出血量(0.6ml/kg)明显低于剖腹手术组(8.4ml/kg)(P<0.0001)。腹腔镜组有 2 例局部复发,剖腹手术组有 2 例远处转移复发。两组 5 年总生存率均为 93.8%。

结论

对于直径≤60mm 且手术时无 IDRFs 的腹部神经母细胞瘤,腹腔镜切除术是一种可行且安全的方法,其长期结果与剖腹手术相当。

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