Comparison of open and laparoscopic surgery for pediatric retroperitoneal teratoma: a single-center experience.
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BACKGROUND: The role of laparoscopic surgery in pediatric retroperitoneal teratomas remains unclear because of limited working space and vascular injury concerns. This study compared outcomes of open and laparoscopic surgeries for pediatric retroperitoneal teratomas. METHODS: We retrospectively reviewed 24 children who underwent resection of a retroperitoneal teratoma at a single center between 2002 and 2024. Thirteen underwent open surgery and 11 underwent laparoscopic surgery. Patient characteristics and perioperative outcomes were compared between groups. Continuous variables were analyzed using the Mann-Whitney U test and categorical variables using exact tests. RESULTS: Open surgery was performed earlier, whereas laparoscopic surgery was introduced later and became more common. No statistically significant differences were observed between open and laparoscopic groups in age at surgery, sex, body weight, height, tumor location, tumor volume, tumor volume/body surface area, or vessel encasement. Operative time was longer in the laparoscopic group than in the open group (median, 304 vs. 146 min; P = 0.003), whereas postoperative hospital stay was shorter (7 vs. 10 days; P = 0.039). Blood loss, intraoperative tumor rupture, vessel dissection, time to oral intake, and postoperative complication rates did not differ significantly between groups. No laparoscopic cases required conversion to open surgery. No recurrences were observed in either group. CONCLUSIONS: Laparoscopic resection appears to be a feasible option for selected pediatric patients with retroperitoneal teratoma. In this small retrospective series, laparoscopic resection was completed without conversion to open surgery and showed no apparent increase in perioperative complications or recurrence during the available follow-up period.