International Society of Paediatric Surgical Oncology (IPSO) Mininally Invasive Surgery Guidelines

Israel Fernandez-Pineda, Simone de Campos Vieira Abib, Tristan Boam, Diego Aspiazu Salinas, Samer Michael, J.Ted Gerstle, Steven Warmann, Jorg Fuchs, Alyssa Stetson, Gloria Gonzalez, Greg Tiao, Timothy B. Lautz, Rodrigo Chaves Ribeiro, Roshni Dasgupta, Jaime Shalkow-Klincovstein, Cristian Puerta, Andrew M. Davidoff, M. Cornet, J.Grosman, A.Pire, Sabine Sarnacki, Thomas Blanc, Abdelhafeez H. Abdelhafeez,

Guest Editor: Israel Fernandez-Pineda

International Society of Paediatric Surgical Oncology (IPSO) Mininally Invasive Surgery Guidelines

Israel Fernandez-Pineda, MD

Department of Paediatric Surgery, Children’s Health Ireland at Crumlin Hospital, Dublin (Ireland)

Corresponding author: Israel Fernandez-Pineda

Email: israel.fernandez@childrenshealthireland.ie

Paediatric oncology surgeons play a critical role in diagnosing, staging and treating malignant solid tumours. Over the years, a more tailored surgical approach of the primary tumour site and the metastatic disease has been advocated by many solid tumour protocols. In the last few decades, the integration of Minimally Invasive Surgery (MIS) into the surgical practice of paediatric oncology has become increasingly popular. The benefits of MIS are well established in non-oncologic surgery, but the role of MIS in paediatric solid tumours is still emerging and in many cases lacks proper evidence. Ecancer has already published guidelines dedicated to paediatric surgical oncology from experts in the field of childhood cancer, but these guidelines were more focused on open surgery and general knowledge.

The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with paediatric surgical oncology worldwide. These IPSO-MIS guidelines are focused on how to apply MIS to paediatric patients with solid tumours. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High- (HICs) and Low- and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. Paediatric surgeons dedicated to this field should have knowledge in both paediatric surgical oncology along with experience and expertise in paediatric MIS to provide optimal care and outcome for their patients. Surgical guidelines from the oncology protocols should be followed and indications/contraindications for MIS in paediatric cancer patients should be evaluated on each case. MIS advantages include less postoperative pain, early discharge, better cosmetic result and early initiation of adjuvant therapy including chemotherapy and radiation therapy. Disadvantages include the lack of palpation, potential tumor spillage and trocar site recurrences. MIS is gaining more and more acceptance in paediatric surgical oncology, therefore paediatric surgical oncologists should be aware of the general MIS recommendations. We hope that this initiative will benefit children worldwide in the best way possible.

References

Spurbeck WW, Davidoff AM, Lobe TE, Rao BN, Schropp KP, Shochat SJ. Minimally invasive surgery in pediatric cancer patients. Ann Surg Oncol. 2004 Mar;11(3):340-3.

Abdelhafeez A, Ortega-Laureano L, Murphy AJ, Davidoff AM, Fernandez-Pineda I, Sandoval JA. Minimally Invasive Surgery in Pediatric Surgical Oncology: Practice Evolution at a Contemporary Single-Center Institution and a Guideline Proposal for a Randomized Controlled Study. J Laparoendosc Adv Surg Tech A. 2019 Aug;29(8):1046-1051.

Fuchs J. The role of minimally invasive surgery in pediatric solid tumors. Pediatr Surg Int. 2015 Mar;31(3):213-28.