Paediatric abdominal oncovascular surgery – a single-centre experience and review of the literature

Abstract

Background: Oncovascular surgery is a term identifying vascular resection in the context of tumour resection, which is still controversial in children. We present our experience and review of the literature.

Methods: A retrospective review of children who underwent abdominal oncovascular procedures in our institution from 2018 to 2022 was conducted. Type of operation and postoperative outcome was described. Literature review on oncovascular surgery in children is presented.

Results: Seven cases were identified, mean age 8.25 years (9 months–14 years) – two bilateral paragangliomas, two Wilms tumours, one pancreatoblastoma, one solid pseudopapillary tumour of the pancreas (SPN), and one hepatoblastoma. Five procedures were performed on the inferior vena cava – three patients underwent cavectomy with no reconstruction, one had a partial cavectomy with primary repair, and one had resection and reconstruction with a polytetrafluoroethylene (PTFE) graft which complicated with leaking and infection. Two patients underwent a pancreaticoduodenectomy with portal vein resection and primary anastomosis. Five patients were completely resected (R0), two patients had microscopically positive margins (R1). One patient was lost to follow-up post-resection; all others were alive at last follow-up.

Conclusion: Vascular resection can allow complete tumour resection in locally advanced paediatric tumours. Oncovascular surgery in children is feasible and may be beneficial in selected cases.