Minimally invasive surgery in the diagnosis and treatment of childhood cancer

Abstract

The use of MIS in children with malignancies has been relatively slow to evolve but this modality can now be considered an acceptable approach for selected tumors. In the abdomen, laparoscopy can be used primarily for biopsy of new lesions or for second look purposes. Also, it is being increasingly utilized for resection of Wilms tumors or other renal lesions that have previously been treated with chemotherapy and have decreased significantly in size. Also, another good candidate is a small baby with a suspected neuroblastoma that is well localized. The use of thoracoscopy has matured faster than laparoscopy due to the fact that biopsy of mediastinal masses or resections of pulmonary lesions are straightforward procedures in children. Also, resection of posterior mediastinal masses can be accomplished thoracoscopically. This chapter will describe the use of laparoscopy and thoracoscopy for children with cancer, the impact of these modalities on tumor cell behavior, and will review the recent literature describing these approaches in children with cancer.