Exploring the frontier in robotic pediatric cancer surgery: when to move forward and when to stop
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · May 2024 · 1 min read
In brief
In brief
Retrospective analysis of 38 pediatric cancer patients undergoing robotic-assisted tumor resection shows safety and efficacy despite 31.58% open conversion rate, primarily due to vascular challenges. All patients resumed chemotherapy on schedule with low complication rates, emphasizing importance of patient selection and technical expertise during learning curve.
- Robotic-assisted tumor resection is safe and effective in pediatric oncology, even during the learning curve phase with proper patient selection.
- Vascular challenges were the primary reason for open conversion (23.68% of cases), highlighting the need for careful preoperative vascular assessment.
- Neuroblastoma was the most common indication (n=19), with adrenalectomy being the predominant procedure (28.94% of cases).
- All patients resumed scheduled postoperative chemotherapy without delay, demonstrating minimal impact on oncologic treatment protocols.
- Multidisciplinary tumor board discussion and careful consideration of tumor characteristics are critical for successful robotic case selection.
Written by the GCMD Library team from the article.
Abstract
Purpose
In recent years, the use of robotic-assisted minimally invasive surgery in pediatric oncology has increased. Despite its benefits, its adoption remains limited. This single-center retrospective analysis examines technical nuances, indications, and surgical limitations to prevent complications.
Methods
Data from cancer patients treated robotically in 2015–2016 (Group A) and 2020–2022 (Group B) were compared. Decision-making considered tumor characteristics and risks, guided by multidisciplinary tumor board discussions. Data collected included demographics, intra/post-operative details, and tumor classifications. Statistical analysis evaluated influencing factors.
Results
Thirty-eight pediatric patients underwent robotic-assisted tumor resection, the median age was 5 years and weight 21.5 kg. Group A had higher median age and weight. Lesions included 23 malignant, 9 borderline, 5 benign cases; neuroblastoma (n = 19) was prevalent procedure and adrenalectomy was the predominant (28.94%). Open conversion occurred in 12 patients (31.58%), mainly due to vascular challenges (23.68%). Intraoperative complications were 10.53%, postoperative 7.9%. About 27% discharged by the third postoperative day; longer stays were needed for complex cases. All resumed post-op chemotherapy as scheduled, and all alive during follow-up.
Conclusions
Our study confirms the safety and efficacy of robotic-assisted tumor resections in pediatric oncology, even during the learning phase, emphasizing the importance of learning curve, patient selection, and trocar positioning.