Laparoscopic surgery for neuroblastoma identified by mass screening

Area of Science:

• Pediatric Surgery
• Oncology
• Minimally Invasive Surgery

Background:

• Neuroblastomas detected via mass screening exhibit distinct biological and epidemiological characteristics compared to clinically diagnosed tumors.
• Screen-detected neuroblastomas demonstrate favorable biological features, with a high 5-year survival rate (97%), questioning the necessity of aggressive surgical interventions.

Purpose of the Study:

• To evaluate the feasibility and outcomes of laparoscopic adrenalectomy for treating small, screen-detected neuroblastomas in infants.
• To assess the safety and efficacy of a minimally invasive surgical approach in this specific patient population.

Main Methods:

• Laparoscopic adrenalectomy was performed on three infants (one boy, two girls) with small (<20 mm) adrenal lesions.
• Procedures involved general anesthesia, five trocars, abdominal wall traction, and low intraabdominal pressure (<4 mm Hg).
• Tumor excision was completed using a containment bag, with no lymphadenopathy noted.

Main Results:

• All three patients underwent successful laparoscopic adrenalectomy with an uneventful postoperative course.
• Histological examination revealed favorable Shimada type histology and no N-myc gene amplification in the resected tumors.
• Patients remained disease-free with no recurrence or metastasis during 17–22 months of follow-up.

Conclusions:

• Laparoscopic adrenalectomy is a viable and safe surgical option for infants with select screen-detected neuroblastomas.
• The favorable biology of these tumors supports the use of minimally invasive techniques, potentially reducing surgical morbidity.