Background : Minimal access surgery for "pediatric" tumors is still controversial and literature is mostly focused in the "open" procedures. We are presenting our experience with children`s who underwent MAS resection for selected tumors. Special attention was paid to the adequacy and safety with assessment of recovery, morbidity, cosmesis and recurrence.
Methods: Retrospective review of 24 consecutive patients who underwent complete tumor excision by MAS approach over the last 6 years. Most of the tumors were found incidentally with different imaging modalities.
Results: Nine patients underwent thoracoscopic and fifteen laparoscopic resection. The median age was 4.5 years, median weight 13.5 kg . Tumor size ranged from 3 to 8 cm maximum diameter. One conversion was done for intra operative bleeding and second for bowel resection / anastomosis . The mean hospital stay was 3 days - related mostly to IV analgesia . Final diagnoses included: ganglioneuroma (n = 6), neuroblastoma (n = 1), pheochromocytoma (n = 1), adrenal adenoma (n = 2) castelman disease ( n= 2), lymphoma (n = 2) , thymoma ( n=1) , GIST ( n=1) and dermoid tumor (n = 8). No recurrence was detected in relatively short mean follow-up of 2.3 y.
Conclusions: MAS for tumor resection can be performed safely in carefully selected patients with excellent outcomes in terms of minimal discomfort, rapid recovery, and excellent cosmesis. Studies with larger volume of patients and longer follow up are required to adequately assess recurrence rate.
