WOFAPS 2025 8th World Congress of Pediatric Surgery

Dmitry Akhaladze, Ivan Tverdov, Gavriil Rabaev

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

The minimally invasive hepatectomies have become widespread during last decades. However very little is known about the safety and role of laparoscopic liver resections in children. The main reason is the low incidence of liver tumors compared to adult patients. Although laparoscopic liver resection in pediatric oncology is not well-reported, the number of successful laparoscopic liver resections in children is increasing these years. The objectives of this research are to compare short- and long-term results after liver resections in children depending on laparoscopic or conventional approach.

All children with liver tumors who underwent hepatectomy between 2018 and 2025 were included. Age, sex, diagnosis, tumor size, volume, localization, type of liver resection, operative time, blood lose, intra- and postoperative complications have been retrospectively evaluated. The sample was divided in two groups depending on approach (laparoscopic or open). Data management and analysis were performed using SPSS 26.0. Chi-squared, Mann-Whitney U-Test, independent sample t-tests were carried out to assess whether groups are doddered in sort term results. Kaplan-Meier curves were used to compare overall and event-free survival. Propensity score matching was performed to reduce selection bias with 10 confounders (weight, height, sex, age, tumor volume and size, extent of liver resection, previous laparotomy, neoadjuvant chemotherapy, malignancy).

262 patients underwent liver resection (68 hepatectomies via minimally invasive approach). The complications rate was similar in both groups. Laparoscopic resections have been significantly associated with shorter postoperative period, analgesia and drain removal. Long term results were comparable between groups too.

This study has confirmed the main advantages and safety of minimally invasive approach for liver resections in children. Further prospective research and previously accumulated experience in laparoscopic liver resections have been determined further development and expanding of this technique in pediatric oncology.