Minimally Invasive Surgery for Pediatric Tumors – Current State of the Art

Abstract

During recent years, minimally invasive surgery (MIS) has become the standard approach for various operations in infants and children. This also holds true for surgery in children with solid tumors. Meanwhile, more and more oncological biopsies and resections are being performed laparoscopically or thoracoscopically. Despite its increasing role in pediatric tumor surgery, the different national and international multicenter trial groups have not yet implemented MIS within guidelines and recommendations in most of the current treatment protocols. An increasing number of reports describe a potential role of MIS in the different entities of pediatric surgical oncology. Over the time, there has been a diverse development of this approach with regard to the different neoplasms. The aim of this article is to give an overview and to describe the current state of the art of MIS in pediatric solid tumors.

Endosurgery in Diagnosis of Tumor Diseases in Children

“…Так, эндохирургия стала стандартным методом диагностики и лечения в детской онкологии [21,22]. Все чаще в обзорах литературы у зарубежных авто-ров делается акцент на строгом соблюдении онко-логических принципов при использовании эндохи-рургии [22,23].…”

“…Все чаще в обзорах литературы у зарубежных авто-ров делается акцент на строгом соблюдении онко-логических принципов при использовании эндохи-рургии [22,23]. Также отмечаются преимущества данного метода -низкая травматичность, мини-мальная кровопотеря, малое число осложнений в послеоперационном периоде.…”

Current Concepts in Surgery for Wilms Tumor—The Risk and Function-Adapted Strategy

“…It needs to be stated that in every case nephron-sparing resection, if possible, has to have a priority over laparoscopy, being the technique bringing real advantage to the child. [26][27][28][29] A recently reported series from SIOP evidenced that laparoscopic tumor nephrectomy may offer an acceptable oncological outcome (24 of 24 are alive, median follow-up 47 months) in case of careful selection of patients (0.6% of the whole group), whereas adequate lymph node sampling in the majority of patients was missing, with sampling of lymph nodes according to the SIOP 2001 protocol in two cases only. 26,30,31 It is recommended that the surgical team undertaking minimally invasive tumor nephrectomy needs to be equally and highly experienced in both laparoscopy and surgical oncology.…”

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

“…Its application in pediatric surgical oncology has encountered several concerns including limited tumor manipulation, the associated challenges of vascular involvement seen in neuroblastic tumors, and the risk of spillage. It has thus mostly been applied to tumors that can be fragmented such as neuroblastic tumors …”

“…It has thus mostly been applied to tumors that can be fragmented such as neuroblastic tumors. [5][6][7][8] The first series of Wilms tumors (WT) treated by an MIS approach preoperative treatment. 10 In 2014, the Renal Tumor Strategy Group of the International Society of Paediatric Oncology (SIOP) published the largest cohort of WT treated with MIS, 11 and in the same year, SIOP released the Umbrella protocol 12,13 with criteria for laparoscopic nephrectomy ( Table 1).…”