Minimally invasive surgery and clinical decision-making for pediatric malignancy

Background: Minimally invasive surgery (MIS) is an ideal way to obtain biop sy specimens in children with cancer. We examined the safety, reliability a nd outcome of decisions made based on tissue obtained using MIS. Methods: Fifty-nine oncology patients underwent 62 MIS procedures between J anuary 1994 and July 1998. Complications, biopsy results, and outcomes were reviewed. Results: The study population comprised 32 boys and 27 girls, with an avera ge age of 8.8 years. There were 47 thoracoscopic and 15 laparoscopic operat ions. Laparoscopic procedures included initial biopsy, determination of res ectability, and second-look exam. Thoracoscopic procedures included 40 lung biopsies and seven biopsies/resections of mediastinal masses. Diagnostic a ccuracy was 100% in all cases. No patient was found retrospectively to have been inadequately treated based on decisions made from tissue obtained by MIS. Conclusion: MIS is a safe and accurate means of obtaining tissue in pediatr ic oncology patients. Treatment decisions can be made accurately and with c onfidence using these techniques.