Journal of pediatric surgery · 2026
Systematic review and national cancer database analysis of minimally invasive liver surgery in children.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Ziogas Ioannis A, Kakos Christos D, Kokkinakis Stamatios, Khomiak Andrii, Yoeli Dor, Adams Megan A, Marantos Aggelos, Dionysis Theodoros T, Lovvorn Harold N, Zamora Irving J, Hills-Dunlap Jonathan L, Corkum Kristine S, Roach Jonathan P
Аннотация
INTRODUCTION: Despite the broader adoption of minimally invasive liver surgery (MILS) for adults, its application in the pediatric population has been mainly documented in single-center reports. We aimed to summarize the current state of evidence of MILS in children.
METHODS: We systematically reviewed PubMed, Scopus, Web of Science, and Cochrane Library databases according to the PRISMA statement for children (<18 years) undergoing MILS (end-of-search date: 03/03/2024). The National Cancer Database (NCDB) was queried for children (<18 years) undergoing MILS (2010-2021).
RESULTS: Forty-one articles reporting on 211 patients were included. The approach was laparoscopic in 91.5%, robotic in 5.7%, and hand-assisted 2.8%. The mean age was 5.4 ± 4.4 years, the mean lesion size was 6.2 ± 3.4 cm, and the most common indications were hepatoblastoma (28.9%) and hydatid cyst (27.0%). Most underwent cyst surgery (43.0%), followed by minor liver resection (37.7%). Five (2.4%) had conversion to open. The mean operative time was 162.1 ± 99.1 min and mean length of stay was 6.4 ± 4.9 days. Over a mean follow-up of 22.9 ± 24.6 months, one patient died (0.5%). Forty-six children underwent MILS in NCDB (45 laparoscopic, 1 robotic). The mean age was 4.7 ± 5.7 years and mean tumor size was 1.0 ± 1.3 cm. Most underwent wedge/segmental resection (47.8%). Five (10.9%) had conversion to open and mean length of stay was 6.3 ± 5.0 days.
CONCLUSION: This first systematic review and NCDB analysis establishes feasibility benchmarks of MILS in children for both benign and malignant liver lesions. MILS is associated with 2-11% conversion rate and mean length of stay of 6 days.
LEVEL OF EVIDENCE: Level III evidence.
METHODS: We systematically reviewed PubMed, Scopus, Web of Science, and Cochrane Library databases according to the PRISMA statement for children (<18 years) undergoing MILS (end-of-search date: 03/03/2024). The National Cancer Database (NCDB) was queried for children (<18 years) undergoing MILS (2010-2021).
RESULTS: Forty-one articles reporting on 211 patients were included. The approach was laparoscopic in 91.5%, robotic in 5.7%, and hand-assisted 2.8%. The mean age was 5.4 ± 4.4 years, the mean lesion size was 6.2 ± 3.4 cm, and the most common indications were hepatoblastoma (28.9%) and hydatid cyst (27.0%). Most underwent cyst surgery (43.0%), followed by minor liver resection (37.7%). Five (2.4%) had conversion to open. The mean operative time was 162.1 ± 99.1 min and mean length of stay was 6.4 ± 4.9 days. Over a mean follow-up of 22.9 ± 24.6 months, one patient died (0.5%). Forty-six children underwent MILS in NCDB (45 laparoscopic, 1 robotic). The mean age was 4.7 ± 5.7 years and mean tumor size was 1.0 ± 1.3 cm. Most underwent wedge/segmental resection (47.8%). Five (10.9%) had conversion to open and mean length of stay was 6.3 ± 5.0 days.
CONCLUSION: This first systematic review and NCDB analysis establishes feasibility benchmarks of MILS in children for both benign and malignant liver lesions. MILS is associated with 2-11% conversion rate and mean length of stay of 6 days.
LEVEL OF EVIDENCE: Level III evidence.