Robot-assisted laparoscopic resection of paediatric retroperitoneal neurogenic tumours: a retrospective single-centre study of 117 patients.
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Although robot-assisted laparoscopic surgery (RALS) is increasingly used in paediatric surgery, evidence regarding its safety and feasibility in retroperitoneal neurogenic tumours (RNTs) remains limited. This study aims to evaluate perioperative and short-term oncological outcomes of RALS in children with RNTs. This single-centre retrospective study included all consecutive paediatric patients who underwent RALS for RNTs between May 2020 and May 2025. Patient demographics, tumour characteristics, perioperative outcomes, postoperative complications, and follow-up data were analysed. A total of 117 patients were included; 29 (24.8%) had a single IDRF (image-defined risk factors), and none had multiple IDRFs. Robotic resection was completed in 116 of 117 patients (99.1%). Subgroup completion rates were 100.0% (29/29) among IDRF-positive patients, 92.9% (13/14) among children younger than 5 months, 95.7% (22/23) among those weighing less than 10 kg, and 100.0% (16/16) among those with tumours > 6 cm. One infant required conversion following major haemorrhage during dissection of a tumour invading the inferior vena cava. Complete macroscopic excision was achieved in all patients. Median blood loss was 5.0 mL and median postoperative stay was 3.0 days. Grade IIIb and IVb complications occurred in one patient each, with no 30-day deaths. During a median follow-up of 741 days, one local recurrence and two deaths from systemic tumour progression occurred. RALS was feasible in carefully selected children with RNTs, with a high completion rate and infrequent serious complications. A selected single IDRF, low body weight, young age, or large tumour size should not alone be considered an absolute contraindication to RALS. Multicentre prospective comparative studies are needed to refine selection criteria and assess long-term outcomes.