[Surgical treatment of retroperitoneal neurogenic tumors in children]. / Khirurgicheskoe lechenie detei s neirogennymi opukholyami zabryushinnogo prostranstva.

ABSTRACT

OBJECTIVE: To evaluate feasibility and advantages of laparoscopic access in children with retroperitoneal neurogenic tumors. MATERIAL AND METHODS: A comparative analysis of postoperative results was performed in 2 groups of patients with retroperitoneal neurogenic tumors without IDRF risk factors. Different surgical approaches were applied. The main group (laparoscopic access) consisted of 18 patients. The control group included 22 patients after laparotomy. We compared the following variables surgery time, blood loss, postoperative need for analgesics, intraoperative and postoperative complications, timing of postoperative enteral feeding, postoperative hospital-stay and regional recurrence rate. RESULTS: Duration of laparoscopic and open surgery was similar (80.5 vs. 86.5 min, p>0.05). Intraoperative blood loss was significantly lower in the laparoscopy group (10 vs. 17 ml/kg, p<0.05). Two patients required conversion of laparoscopic approach. In laparotomy group, massive intraoperative bleeding occurred in 1 patient. Early postoperative period was more favorable in the main group compared to the control group. There were no local and metastatic recurrences in delayed postoperative period after laparoscopic surgery. One (4.5%) patient had metastatic recurrence after laparotomy. There were no regional recurrences in this group. CONCLUSION: Laparoscopic resection of neurogenic retroperitoneal tumors in children is feasible if great vessels are not involved in neoplastic process. Open surgery is preferable in patients with invasion of great vessels.