Surgical outcomes of patients with neuroblastoma in a tertiary centre in Hong Kong: A 12-year experience

Introduction: Neuroblastoma has a heterogeneous clinical course. The prognosis varies widely depending on the age of diagnosis, extent of disease and tumour biology. However, the specific clinical outcome of this disease in Hong Kong has not been well characterised thus far. Complete tumour excision has been demonstrated to confer survival benefit on patients with advanced disease even if there is metastasis. Since year 2004, we have adopted a revised, more aggressive surgical approach in managing these patients. Here, we aim to review our experience in the management of this disease. Methods: A retrospective review was performed for the past 12 years to include all patients who presented with neuroblastoma in our institution. Data such as the survival, age at diagnosis, MYCN amplification status, the extent of tumour excision, and stage of the disease were recorded and analysed. Results: 37 patients were included in this study. Overall survival of our patients was 67.6%. Patients with Stage 1, 2 and 4S have 100% survival whereas stage 4 patients only have 41.4% survival. Since our revised surgical approach in 2004, patients who had been operated had a better survival. Survival of stage 4 patients with operation after 2004 was 57.1% whereas the survival of patients at the same stage before 2004 was only 30%. Age at diagnosis, completeness of tumour excision and stage of disease are also correlated with overall prognosis. Further, patients with the presence of MYCN gene amplification have apparently poorer survival but it is not statistically significant due to the small sample size. Conclusion: The management of patients with neuroblastoma remains a challenge. Advanced stage of disease, incomplete tumour excision and increased age at diagnosis were all associated with poor survival. We demonstrated a better survival for those who underwent a more aggressive surgical approach, though this is a technically demanding and time consuming procedure. Thus, the management of advanced neuroblastoma should be centralised in a centre with combined surgical, oncological and paediatric intensive care expertise.published_or_final_versio

Long-term follow-up of childhood duodenal ulcers

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Evaluation of defecative function 5 years or longer after laparoscopic-assisted pull-through for imperforate anus

Background: Laparoscopic anorectoplasty was introduced in 2000, but the procedure has not yet gained universal acceptance. Previous studies, including ours, reported satisfactory early postoperative outcome as compared with posterior sagittal anorectoplasty (PSARP), but mid- to long-term results are not available. Here, we aim to evaluate the mid- to long-term defecative function in these patients. Materials and Methods: A retrospective study was carried out and included all patients who underwent laparoscopic-assisted anorectoplasty for high-/intermediate-type imperforate anus between 2001 and 2005. Their degree of continence was graded according to the Krickenbeck classification and compared with historical controls treated with PSARP. The results were compared using χ 2 test, and P .05). Conclusions: Mid- to long-term follow-up study revealed satisfactory defecative function for patients with high-/intermediate-type imperforate anus after LAR. The outcome is at least as good as PSARP. Longer term follow-up with larger sample size is necessary to demonstrate the benefits of LAR over PSARP. © 2011 Elsevier Inc.postprin

The first report of a single-port laparoscopic nephrectomy in a child

There has been an exponential rise in the use of minimally invasive procedures in surgery, with obvious benefts to patients. Recently, transumbilical single-port laparoscopic surgery has been championed as the next major technical advance. In this article, we report the frst case where single-port laparoscopic surgery has been used to manage a paediatric problem in the region.published_or_final_versio

Use of robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy in a paediatric patient: problem encountered

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Outcomes of Re-Intervention for Laparoscopic Transperitoneal Pyeloplasty in Children

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Inhaled foreign bodies: children with peanut in airway

Foreign body aspiration is a common problem in young children. Many patients present after a significant delay despite having a witnessed choking event. Moreover, their presentations may mimic other common respiratory problems like pneumonia or asthma. It is extremely important to be attentive to history taking and clinical signs that may indicate early bronchoscopy to confirm the diagnosis.published_or_final_versio

Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

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Letters to the editor

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Patient complexity and genotype-phenotype correlations in biliary atresia: a cross-sectional analysis

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