Diarrhea as a postoperative complication of surgically treated retroperitoneal neurogenic tumors in children

Abstract

BACKGROUND: Diarrhea as a result of skeletonization of the superior mesenteric artery (SMA) and celiac trunk after retroperitoneal lymph node dissection is a common complication in adult patients with malignant neoplasms of the pancreas, colon, and retroperitoneal tumors. The reports mentioning this complication in the treatment of neurogenic tumors in children are scarce. AIM: This study aims to improve the surgical treatment results of locally advanced retroperitoneal neuroblastomas by studying which factors influence the development of prolonged postoperative diarrhea. MATERIALS AND METHODS: An analysis of the treatment results in patients with locally advanced neurogenic retroperitoneal neoplasms at the Dmitry Rogachev national medical research center of pediatric hematology, oncology, and immunology from 2018 to 2020 was conducted. All patients from this cohort underwent SMA and celiac trunk dissection. RESULTS: During this period, surgeries with dissection of the SMA and celiac trunk were performed in 29 patients. In four (13%) cases, prolonged diarrhea was noted (median duration, 136.5 days with a frequency of up to 13 times a day). Assessment of the dependence of diarrhea frequency on complete dissection or preservation of the tumor component in the SMA and celiac trunk showed no significant differences. CONCLUSIONS: The complete removal of a neurogenic tumor improves prognosis in patients with a locally advanced form of the disease, but it is associated with the risk of long-term intractable complications. This study does not confirm the opinion that preservation of the tumor component on the SMA prevents its denervation and postoperative diarrhea.