Ding Ning,Rao Pinde,Wu Wenbo,et al.Two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma[J].Journal of Clinical Pediatric Surgery,,21():136-140.[doi:10.3760/cma.j.cn.101785-202012030-007]
Two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma
- Keywords:
- Adrenal Neuroblastoma; Surgical Procedures; Operative; Laparoscopy; Surgical Approach; Child
- Abstract:
- Objective To evaluate the reliability and safety of two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma.Methods A retrospective study was performed for five children undergoing laparoscopic adrenalectomy from February 2018 to August 2020.There were 6 boys and 3 girls with an average age of 22(1-65) months.The involved side was left (n=3) and right (n=6).There were abdominal pain (n=2), hematuria (n=1), diarrhea (n=1), abdominal distension (n=1) and non-discomfort (n=4).Retroperitoneal (n=2) and transperitoneal (n=3) laparoscopies were performed.All procedures were successfully performed without any conversion into open surgery.The average operative duration was 137 min, the mean estimated volume of blood loss 16.3(5-40) ml and the mean tumor diameter 4.3(2.5-5.4) cm.Histopathological examination hinted at neuroblastoma (n=5), ganglioneuroblastoma (n=3) and ganglioneuroma (n=1).Results All of them recovered well postoperatively during a mean follow-up period of 8.6(2-35) months.There was no onset of recurrence or metastasis.Conclusion Two different approaches of laparoscopic adrenalectomy may be safely and effectively performed for neuroblastoma.Retroperitoneal laparoscopy offers an advantage over exposing and handling blood vessels while transperitoneal laparoscopy is superior for operating space.
References:
[1] Lam AK.Update on adrenal tumours in 2017 World Health Organization (WHO) of endocrine tumours[J].Endocr Pathol,2017,28(3):213-227.DOI:10.1007/s12022-017-9484-5.
[2] 陈琛君,郭云飞,马耿,等.儿童肾上腺区域肿瘤的诊断、治疗及预后分析[J].中华实用儿科临床杂志,2018,33(23):1781-1784.DOI:10.3760/cma.j.issn.2095-428X.2018.23.006. Chen CJ,Guo YF,Ma G,et al.Diagnosis,treatment and prognosis of adrenal tumor in children[J].Chin J Appl Clin Pediatr,2018,33(23):1781-1784.DOI:10.3760/cma.j.issn.2095-428X.2018.23.006.
[3] Yamamoto H,Yoshida M,Sera Y.Laparoscopic surgery for neuroblastoma identified by mass screening[J].J Pediatr Surg,1996,31(3):385-388.DOI:10.1016/S0022-3468(96)90743-5.
[4] St Peter SD,Valusek PA,Hill S,et al.Laparoscopic adrenalectomy in children:a multicenter experience[J].J Laparoendosc Adv Surg Tech A,2011,21(7):647-649.DOI:10.1089/lap.2011.0141.
[5] 陈艳,杨刚刚,黄轶晨,等.机器人辅助腹腔镜下儿童肾上腺肿瘤切除术的初步探讨[J].中华小儿外科杂志,2019,40(2):137-142.DOI:10.3760/cma.j.issn.0253-3006.2019.02.009. Chen Y,Yang GG,Huang YC,et al.Preliminary experience of robotic adrenalectomy for children with adrenal tumor[J].Chin J Pediatr Surg,2019,40(2):137-142.DOI:10.3760/cma.j.issn.0253-3006.2019.02.009.
[6] 姚伟,董岿然,李凯,等.局限性肾上腺神经母细胞瘤腹腔镜手术疗效评估[J].中华小儿外科杂志,2014,35(6):444-447.DOI:10.3760/cma,j,issn.0253-3006.2014.06.011. Yao W,Dong KR,Li K,et al.Evaluations of laparoscopic adrenalectomy for local adrenal neuroblastoma[J].Chin J Pediatr Surg,2014,35(6):444-447.DOI:10.3760/cma.j.issn.0253-3006.2014.06.011.
[7] Conzo G,Tartaglia E,Gambardella C,et al.Minimally invasive approach for adrenal lesions:systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications[J].Int J Surg,2016,28(S1):S118-S123.DOI:10.1016/j.ijsu.2015.12.042.
[8] Brisse HJ,Mccarville MB,Grannta C,et al.Guidelines for imaging and staging of neuroblastic tumors:consensus report from the International Neuroblastoma Risk Group Project[J].Radiology,2011,261(1):243-257.DOI:10.1148/radiol.11101352.
[9] Gagner M,Lacroix A,Bolte E.Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma[J].N Engl J Med,1992,327(14):1033.DOI:10.1056/NEJM199210013271417.
[10] 曾玉佩,何大维,李旭良,等.腹腔镜及开腹手术切除儿童肾上腺区神经源性肿瘤的对比研究[J].中华小儿外科杂志,2017,38(6):424-428.DOI:10.3760/cma.j.issn.0253-3006.2017.04.007. Zeng YP,He DW,Li XL,et al.Comparative analysis of laparoscopic versus open adrenalectomy for adrenal neurogenic tumors in children[J].Chin J Pediatr Surg,2017,38(6):424-428.DOI:10.3760/cma.j.issn.0253-3006.2017.04.007.
[11] Lezoche G,Baldarelli M,Cappelletti Trombettoni MM,et al.Two decades of laparoscopic adrenalectomy:326 procedures in a single-center experience[J].Surg Laparosc Endosc Percutan Tech,2016,26(2):128-132.DOI:10.1097/SLE.0000000000000249.
[12] Shah J,Vale J,Darzi A.Laparoscopy for urological cancers[J].BJU Int,2001,88(6):493-499.DOI:10.1046/j.1464-410X.2001002318.x.
[13] Henry JF,Sebag F,Iacobone M,et al.Results of laparoscopic adrenalectomy for large and potentially malignant tumors[J].World J Surg,2002,26(8):1043-1047.DOI:10.1007/soo268-002-6666-0.
[14] Kadamba P,Habib Z,Rossi L.Experience with laparoscopic adrenalectomy in children[J].J Pediatr Surg,2004,39(5):764-767.DOI:10.1016/j.jpedsurg.2004.01.043.
[15] Al-Shanafey S,Habib Z.Feasibility and safety of laparoscopic adrenalectomy in children:special emphasis on neoplastic lesions[J].J Laparoendosc Adv Surg Tech A,2008,18(2):306-309.DOI:10.1089/lap.2007.0166.
[16] Group IPE.IPEG guidelines for the surgical treatment of adrenal masses in children[J].J Laparoendosc Adv Surg Tech A,2010,20(2):vii-ix.DOI:10.1089/lap.2010.9999.
[17] 胡嘉健,王焕民.神经母细胞瘤手术后并发症及预防[J].临床小儿外科杂志,2017,16(5):422-425.DOI:10.3969/j.issn.167-6353.2017.05.002. Hu JJ,Wang HM.Complications and prevention of neuroblastoma after operation[J].J Clin Ped Sur,2017,16(5):422-425.DOI:10.3969/j.issn.167-6353.2017.05.002.
[18] 杨超,王珊,李长春,等.3D打印技术在儿童腹膜后神经母细胞瘤血管骨骼化手术中的应用价值探讨[J].临床小儿外科杂志,2019,18(5):376-380.DOI:10.3969/j.issn.1671- 6353.2019.05.008. Yang C,Wang S,Li CC,et al.Application of three-dimensional printing technology during vascular skeletal surgery for children with retroperitoneal neuroblastoma[J].J Clin Ped Sur,2019,18(5):376-380.DOI:10.3969/j.issn.1671-6353.2019.05.008.
Memo
收稿日期:2020-03-08。
基金项目:江西省卫健委科研计划项目（202110098）
通讯作者:饶品德,Email:65991994@qq.com