Thoracic neuroblastoma: a retrospective review of our institutional experience with comparison of the thoracoscopic and open approaches to resection
Thoracic neuroblastoma: a retrospective review of our institutional experience with comparison of the thoracoscopic and open approaches to resection
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DOI：
10.1016/j.jpedsurg.2010.03.018
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发表时间：
2010-08-01
影响因子：
2.4
通讯作者：
Irwin, Chetan
中科院分区：
文献类型：
--
作者：
Malek, Marcus M.;Mollen, Kevin P.;Irwin, Chetan
目的：神经母细胞瘤是儿童最常见的颅外实体瘤。20%的神经母细胞瘤发生在胸腔。方法：对1990-2007年间在本院接受胸神经母细胞瘤切除术的所有儿童的病历资料进行回顾分析。我们评估了接受开腹和胸腔镜术的患者，并比较了两组患者的人口学特征、病理情况、分期、手术细节、并发症和预后。结果：在研究期间共发现149例神经母细胞瘤，其中36例(24%)位于胸部。其中36例患者接受了37次手术治疗原发胸神经母细胞瘤。26例采用开胸手术，其余11例采用胸腔镜术。我们没有观察到患者的人口统计学差异，包括平均年龄、性别或种族。两组肿瘤的组织学状况、位置、手术切缘、淋巴状态和分期相似。两组手术时间相似，但胸腔镜组住院时间较短(2.0天，范围1~7天比3.5天；开放组2~8天，P=0.01)。微创组的估计失血量也较少(中位数为10毫升；范围为0-75毫升对25毫升；开放组为5-650毫升；P=0.02)。结果回顾显示，两组患者在并发症、复发、存活率或无病存活率方面没有显著差异。结论：回顾18年来胸腔神经母细胞瘤的治疗结果表明，胸腔镜术是治疗这种肿瘤的有效方法，与开胸手术相比，其住院时间更短，出血量更少。(C)2010 Elsevier Inc.保留所有权利。
Purpose: Neuroblastoma is the most common extracranial solid tumor in children. Twenty percent of all neuroblastomas arise in the thorax. This study evaluates the open vs thoracoscopic resection of thoracic neuroblastoma.Methods: A retrospective chart review was conducted from the medical records of all children undergoing resection of a thoracic neuroblastoma from 1990 to 2007 at our institution. We evaluated patients who underwent open vs thoracoscopic resection and compared demographics, pathologic condition, stage, operative details, complications, and outcomes between the 2 groups.Results: A total of 149 cases of neuroblastoma were identified during the study period, 36 (24%) of which had tumor located in the thorax. Thirty-six of these patients underwent 37 operations for primary thoracic neuroblastoma. Open thoracotomy was used in 26 cases with the thoracoscopic approach to resection used in the remaining 11. We observed no differences in patient demographics including mean age, sex, or ethnicity. Tumors in both groups were of similar histologic condition, location, surgical margin, lymph node status, and stage. The length of operation was similar between the 2 groups, but length of stay was shorter in the thoracoscopic group (2.0 days; range, 1-7 days vs 3.5 days; range, 2-8 for the open group; P = .01). Estimated blood loss was also less in the minimally invasive group (median, 10 mL; range, 0-75 mL vs 25 mL; 5-650 mL in the open group; P = .02). Review of outcomes showed no significant difference in complications, recurrence, survival, or disease-free survival between these 2 groups.Conclusions: This retrospective review of thoracic neuroblastoma for an 18-year period shows that thoracoscopic resection is an effective approach to this tumor and offers shorter length of stay and decreased blood loss when compared to open thoracotomy. (C) 2010 Elsevier Inc. All rights reserved.