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Laparoscopic Resection of Abdominal Neuroblastoma

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Abstract

Background

Since indications for laparoscopic adrenalectomy have progressively expanded to pediatric surgery, preliminary reports have studied the laparoscopic approach for abdominal neuroblastoma (NB). We aimed to report on the indications and the results of laparoscopic resection in a large series of abdominal NBs.

Methods

A retrospective multicenter study included 45 children with abdominal NBs (28 localized, 11 stage 4, 6 stage 4s) and laparoscopic resection of their abdominal primary tumor. Primary site of the tumor was the adrenal gland in 41 cases and retroperitoneal space in 4. The median age at surgery was 12 months (1–122); median tumor size was 37 mm (12–70). Resection was performed through transperitoneal laparoscopy (n = 38) or retroperitoneoscopy (n = 7).

Results

Complete macroscopic resection was achieved in 43 of 45 children (96%). The median duration of pneumoperitoneum was 70 min (30–160), and the length of hospital stay was 3 days (2–9). Four procedures (9%) were converted to open surgery, and tumor rupture occurred in three cases. Of the 28 children with localized disease, there was a 96% overall survival (OS) rate after a median follow-up of 28 months (4–94). There was one local relapse in this subgroup, with subsequent complete remission. For the entire 45-children cohort, four children died and three presented a recurrence resulting in OS, disease-free survival, and event-free survival rates of 84% ± 8.1, 84% ± 8.2, and 77% ± 9.1 respectively.

Conclusion

Laparoscopic resection of abdominal primary allows effective local control of the disease in a wide range of clinical situations of neuroblastoma, with an acceptable morbidity.

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Acknowledgment

We thank the surgeons and pediatricians from the following institutions, who contributed to this study: Centre Hospitalier Universitaire de Caen (P. Boutard, T. Petit, P. Ravasse), Hôpital Debrousse, Lyon (PY. Mure, P. Mouriquand), Hôpital de la Timone, Marseille (C. Coze, P. De Lagausie, A. Delarue), Hôpital Mère-Enfant, Nantes (Y. Héloury, MD. Leclair, F. Méchinaud, C. Thomas), Hôpital Lenval, Nice (A. Deville, C. Soler, H. Steyaert, JS. Valla), Hôpital Robert Debré, Paris (Y. Aigrain, A. Bonnard, P. De Lagausie, P. Philippe-Chomette), Institut Curie, Paris (J. Michon, D. Orbach), Hôpital des Enfants-Malades, Paris (S. Sarnacki), Centre Hospitalier Universitaire de Saint-Etienne (C. Berger, JL. Stephan, F. Varlet), Centre Hospitalier Universitaire de Strasbourg (F. Becmeur, I. Kauffmann, P. Lutz, F. Uettwiller).

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Authors and Affiliations

  1. Department of Paediatric Surgery, Hôpital Mère-Enfant, Nantes, France

    Marc-David Leclair & Yves Heloury

  2. Department of Paediatric Surgery, Hôpital Robert Debré, Paris, France

    Pascal de Lagausie & Pascale Philippe-Chomette

  3. Department of Paediatric Surgery, Hôpital de la Timone, Marseille, France

    Pascal de Lagausie

  4. Department of Paediatric Surgery, CHU de Strasbourg, Strasbourg, France

    François Becmeur

  5. Department of Paediatric Surgery, CHU de Saint Etienne, Saint Etienne, France

    François Varlet

  6. Department of Paediatric Oncology and Haematology, Hôpital Mère-Enfant, Nantes, France

    Caroline Thomas

  7. Department of Paediatric Surgery, Hôpital Lenval, Nice, France

    Jean-Stéphane Valla

  8. Department of Paediatric Surgery, CHU de Caen, Caen, France

    Thierry Petit

  9. Paediatric Surgery, Hôpital Debrousse, Lyon, France

    Pierre-Yves Mure

  10. Department of Paediatric Surgery, Hôpital des Enfants Malades, Paris, France

    Sabine Sarnacki

  11. Department of Paediatric Oncology, Institut Curie, PARIS, France

    Jean Michon

Authors
  1. Marc-David Leclair
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  2. Pascal de Lagausie
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  11. Jean Michon
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  12. Yves Heloury
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Correspondence to Marc-David Leclair.

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Leclair, MD., de Lagausie, P., Becmeur, F. et al. Laparoscopic Resection of Abdominal Neuroblastoma. Ann Surg Oncol 15, 117–124 (2008). https://doi.org/10.1245/s10434-007-9499-0

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  • DOI: https://doi.org/10.1245/s10434-007-9499-0

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