56 THORACOSCOPIC RESECTION OF NEUROBLASTOMAS
Martin Sidler, Katherine Burnand, Theodore Howard, Kate M Cross
Great Ormond Street Hospital, Paediatric Surgery, London, United Kingdom

Abstract
Aim

Surgical resection is an essential part in the treatment of most forms of neuroblastoma. The minimally invasive approach to thoracic tumours has become increasingly popular over the past years. We wanted to review our experience using the thoracoscopic approach to neuroblastoma resection.

Methods

We analysed perioperative data, clinical course and the mid-term outcome of patients undergoing neuroblastoma resection by a single surgeon at a tertiary paediatric surgical centre between 2012 and 2017. The study has been approved by the institution’s clinical audit department.

Results

In our series, 11 patients between the age of 11 to 148 months underwent 12 resections of thoracic paraspinal tumours (Table 1). 8 Patients were operated minimally invasive (MI) and 3 underwent open resections. Among the 8 MI patients, 5 patients presented with image defined risk factors, such as tracheal compression or intraspinal extension. Operative time ranged from 100 to 264 minutes. One patient had local recurrence 5 years after resection. No scoliosis or chest wall deformities were noted during follow up.

An open approach was chosen in 3 patients (4 resections) due to the location of the tumour, intraoperative hemodynamic instability (paraganglioma) or resection of relapse following previous open surgery. A transient postoperative Horner’s syndrome was present in two patients after MI and in one patient after open resection. Median length of stay was 5 or 7 days in the MI or the open group, respectively. Median follow up times for the MI and the open group were 21 and 35.5 months, respectively.

Conclusion

The minimally invasive approach to select thoracic neuroblastic tumours allows a thorough resection even in patients with image defined risk factors. Our current experience demonstrates good clinical outcomes without an increase in morbidity and is our preferred surgical approach for these patients.


Website
Yes