Retroperitoneal tumors and congenital variations in vascular anatomy of retroperitoneal great vessels

• Published in: Journal of pediatric surgery 2019-10, Vol.54 (10), p.2112-2116
• Main Authors: Tip, Sai Woon Merng, Lee, York Tien, Tang, Phua Hwee, Chang, Kenneth Tou En, Soh, Shui Yen, Tan, Ah Moy, Loh, Amos Hong Pheng
• Format: Article
• Language: English
• Subjects: Adolescent; Adrenal Gland Neoplasms - mortality; Adrenal Gland Neoplasms - pathology; Adrenal Gland Neoplasms - secondary; Child; Child, Preschool; Disease-Free Survival; Female; Humans; Intraoperative Complications - etiology; Intraoperative Complications - mortality; Intraoperative Complications - pathology; Kidney Neoplasms - mortality; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Male; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Retroperitoneal Neoplasms - mortality; Retroperitoneal Neoplasms - pathology; Retroperitoneal Neoplasms - surgery; Retroperitoneal Space - blood supply; Retroperitoneal tumors; Retrospective Studies; Spinal Neoplasms - mortality; Spinal Neoplasms - pathology; Spinal Neoplasms - surgery; Surgical complications; Treatment Outcome; Vascular Malformations - mortality; Vascular Malformations - pathology; Vascular variations
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2019.01.002

Variations in vascular anatomy (VIVAs) of the retroperitoneal great vessels are uncommon but can potentially complicate surgical procedures and negatively affect treatment outcomes, yet their incidence and clinical impact are poorly studied. We sought to assess the incidence and clinical impact of VIVAs of retroperitoneal great vessels in patients with retroperitoneal tumors. We retrospectively analyzed imaging, surgical, treatment and survival data of all pediatric patients with retroperitoneal tumors who underwent resection between January 2007 and October 2016, comparing preoperative scans with corresponding intraoperative observations, and subsequent surgical outcomes. Among 66 children with renal, adrenal and paravertebral tumors, 6 (9%) had retroperitoneal VIVAs. Retroperitoneal VIVAs were present only with right-sided tumors and significantly associated with more frequent intraoperative complications (P = 0.013). While the presence of retroperitoneal VIVAs was not directly associated with survival outcomes, relapse was more frequent in patients with VIVAs (33%) than those without (18.3%, P = 0.378), and relapse was also associated with lower overall and event-free survival (P