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[Laparoscopic adrenalectomy for neuroblastoma. Our serie and review of literature].

INTRODUCTION
Neuroblastoma is the most frequent adrenal mass in paediatric patients. Paediatric series about laparoscopic adrenalectomy are scarce, usually including adrenal masses from different origin. Series referring only to neuroblastoma are very rare.


MATERIAL AND METHOD
We present 7 patients between 4 and 48 month of age.


RESULTS
We performed 8 laparoscopic adrenalectomy and one biopsy. Lateral transperitoneal approach was used in all patients. We employed 3 ports on the left side and 4 on the right side. All tumours were extracted into a bag through the most posterior incision. One patient underwent a laparotomy because of important adherences. The average operative time was 88 minutes, and average time before discharging was 48 hours.


CONCLUSIONS
Laparoscopic adrenalectomy is the gold standard in adult patients. Transperitoneal access achieves better working area. Paediatric patients don't have many surgical indications for adrenalectomy and the space inside the patient's body is smaller. Laparoscopy offers a less painful solution than open surgery, so that sooner discharging, and better scar's results. The outcome is similar to traditional surgery. Laparoscopy is an useful and safe procedure in paediatric patients with adrenal neuroblastoma, in very selected cases.