Comparative Analysis Of Laparoscopic Versus Open Adrenalectomy For Adrenal Neurogenic Tumors In Children

Objective : To explore the feasibility and safety of laparoscopic adrenalectomy(LA)for adrenal neurogenic tumors in children.Methods : From May 2006 to May 2016,the clinical data were analyzed retrospectively for 15 surgical cases undergoing abdominal laparoscopic tumor resection.The pathological type were defined as adrenal ganglioneuromas,ganglioneuroblastoma and neuroblastomas.During the same period,the data of the matched-pair group of another 13 patients undergoing open adrenalectomy(OA)were included.Two groups were compared in terms of age,gender,resection type,tumor size,tumor location,clinical stage and tumor pathological type.Statistical analysis was performed for matched-pair group.Results : Statistical differences existed in median tumor bed drainage volume.LA group had less drainage as compared to OA group(40 vs 78 ml,P=0.028),median operative duration was similar for two groups(140 vs 80 min,P=0.064),blood loss volume(20 vs 30 ml,P=0.059),duration of indwelling drainage tube(3.0 vs 4.0 days,P=0.903),time of food intake(24 vs 23 h,P=0.410)and average postoperative stay(7.0 vs 7.0 days,P=0.893).The differences had no statistical significance(P>0.05).In LA group,one case of electrolyte imbalance was promptly relieved by supplement of electrolyte.And another case of lymphatic fistula was managed successfully by keeping a longer drainage time.After a median follow-up period of 36 months,3-year disease-free survivals were 76.2% and 69.9% in LA and matched-pairgroups while 5-year overall survival rates 85.7% and 80.0% respectively.There was no statistical significance.Conclusion: Laparoscopic adrenalectomy for adrenal neurogenic tumor is both safe and mini-invasive with comparable outcomes as open surgery in children.