Single-site retroperitoneoscopy in pediatric metastatic lymphadenopathy.
J Pediatr Surg
; 55(11): 2430-2434, 2020 Nov.
Article
em En
| MEDLINE
| ID: mdl-32276851
ABSTRACT
BACKGROUND:
Retroperitoneoscopic surgery (RS) is increasingly used for the diagnosis, staging, and treatment of solid tumors, but rarely in pediatric surgical oncology for retroperitoneal lymph node dissection (RPLND). Herein, we use single-site RS for RPLND in children and compare the perioperative outcomes with those for the transperitoneal laparoscopic approach (TPLA).METHODS:
A single institution retrospective chart review was performed for patients undergoing single-site RS and TPLA (January 2018 till June 2019). We compared patient demographics, diagnoses, operative times, complications, postoperative analgesia, and length of hospital stay between both groups.RESULTS:
Eight patients (median age of 16.5â¯years) undergoing single-site RS for RPLND and five patients (median age 17â¯years) undergoing TPLA RPLND were compared. Groups were comparable in age, median operative duration (232 vs 234â¯min, pâ¯=â¯0.77), and complications (1 vs 1, pâ¯=â¯0.72). Median postoperative hospital stay and total morphine equivalent doses used postoperatively were significantly lower in the RS group, (0.5 vs 2â¯days, [pâ¯=â¯0.03] and 0.1 vs 0.4â¯mg/kg [pâ¯=â¯0.01], respectively). Eight patients underwent ipsilateral modified template RPLND for paratesticular RMS (six single-site RS and two TPLA) and lymph node metastases were found in 50% of these patients. The rest were resections of metastatic lesions for germ cell tumor and neuroblastoma (two single-site RS and three TPLA).CONCLUSIONS:
Single-site RS is a safe and feasible technique in carefully selected pediatric surgical oncology patients. RS provides an excellent view of the retroperitoneum, requires less postoperative analgesia, and is associated with faster recovery. LEVEL OF EVIDENCE RATING IV.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Testiculares
/
Laparoscopia
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Linfadenopatia
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Humans
/
Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article