International Society of Paediatric Surgical Oncology (IPSO): A Short History, Developments, and Current Status.

The International Society of Paediatric Surgical Oncology (IPSO) was officially inaugurated in 1991 through the creativeness and inspiration of a collective dynamic group of paediatric surgeons committed to advancing childhood cancer. This article traces the origins and birth of IPSO tracking its modern day development to a growing world community of paediatric surgeon oncology members. LEVEL OF EVIDENCE: 5.

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.

Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries.

Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature.

Introduction: In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor.

Methods: A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out.

The feasibility of adrenal-sparing surgery in bilateral adrenal neuroblastoma.

Purpose: Loss of adrenal function is a major concern in the treatment of children with bilateral adrenal neuroblastoma (BAN). We aimed to evaluate the feasibility of adrenal-sparing surgery in this unique subgroup.

Method: Retrospective review of our center's neuroblastoma database was conducted.

Trapdoor anterior thoracotomy for cervicothoracic and apical thoracic neuroblastoma in children.

Purpose: Cervicothoracic and apical thoracic neuroblastoma pose unique surgical challenges. We report our experience with the trapdoor anterior thoracotomy (TAT) approach to overcome these difficulties.

Methods: Retrospective review of our centre's neuroblastoma database was conducted.

Bilateral Ovarian Burkitt's Lymphoma: Successful Treatment with Preservation of Ovarian Function.

Background: Bilateral ovarian Burkitt's lymphoma was diagnosed in a 10-year-old girl who presented with abdominal pain, constipation, and signs of ovarian torsion.

Case: Left salpingo-oopherectomy and biopsy of the right ovary were carried out as initial surgical intervention. She remained well in first complete remission at 25 months after multiagent chemotherapy, with pubertal development on clinical examination, hormonal measurements, and pelvic sonography.

Mesenteric lymphatic ligation in the prevention of chylous fistulae in abdominal neuroblastoma surgery.

Purpose: We evaluated the effectiveness of prophylactic mesenteric lymphatic ligation in preventing iatrogenic chylous fistulae in abdominal neuroblastoma surgery.

Method: All patients who underwent resection of abdominal neuroblastoma between years 2002 and 2013 were included. A change in surgical strategy commenced from August 2010 when routine meticulous mesenteric lymphatic ligation (MLL) before abdominal closure was included in the primary surgery, thereby forming two study groups (Group A: before routine MLL; Group B: after routine MLL).

Abdominal neuroblastoma in a child with inferior vena cava anomaly.

Congenital anomalies of the inferior vena cava are rare. Such anomalies pose great challenges to the surgeon in neuroblastoma surgery, especially when unrecognised preoperatively. We report the first case of an abdominal neuroblastoma detected in a child with a developmental anomaly of the left-sided inferior vena cava.

Surgical management of complications of multimodal therapy.

Multimodality therapies that include surgery, chemotherapy, radiotherapy, and various newer forms of targeted therapies have been commonly applied in childhood cancers. Such modalities are associated with complications that may adversely affect the outcome of cancer treatment. Acute complications that require surgical management form the focus of our discussion.

Pediatric risk of malignancy index for preoperative evaluation of childhood ovarian tumors.

Purpose: This study aimed to develop and provisionally validate a novel scoring index for preoperative cancer-risk prediction in childhood ovarian tumors.

Methods: Fifty-five girls aged 18 and below underwent surgery for ovarian masses between 2004 and 2009. Benign or non-benign histological diagnoses (the latter including all malignant and borderline tumors and tumors containing immature components) were correlated with clinical and biochemical parameters, and blinded scores of ultrasound and computed-tomography using multivariate logistic regression.

Diagnostic delay in pediatric solid tumors: a population based study on determinants and impact on outcomes.

Background: Despite socioeconomic and clinical progress, pediatric tumors continue to present in advanced stage, and may be due to delays in diagnosis. This study aimed to identify factors associated with diagnostic delay (time between symptom onset and diagnosis) in pediatric tumors in a population-based study, and to assess the impact of delay on subsequent outcome.

Procedure: Natural logarithm of delay was retrospectively described for 390 newly diagnosed tumors reported to the Singapore Childhood Cancer Registry from 1997 to 2007.

Gene expression of TRK neurotrophin receptors in advanced neuroblastomas in Singapore--a pilot study.

The clinical hallmark of neuroblastoma is heterogeneity. Biologically, ploidy and N-Myc amplification are currently the only 2 features used to define risk group and to determine therapy. Tyrosine kinase neurotrophin receptors (Trks, including TrkA, TrkB, and TrkC) are important in the clinical and biological behavior of neuroblastomas.

Perforation: a rare complication of choledochal cysts in children.

Purpose: Spontaneous perforation is a rare complication of choledochal cyst (CDC) which is difficult to diagnose due to its nonspecific clinical presentation. The surgical treatment can be either single-staged cyst excision or two-staged procedure with an initial drainage followed by delayed cyst excision. Both biliary duct obstruction and irritation due to refluxed pancreatic juice have been proposed as possible aetiology.

Peritoneal metastases after laparoscopic nephron-sparing surgery for localized Wilms tumor.

A 2-year-old girl was referred for the management of the progression of her localized Wilms tumor. She had undergone laparoscopic nephron-sparing surgery for her right Wilms tumor 3 months earlier. Postoperative chemotherapy was commenced 6 weeks later.

Delays in diagnosis of pediatric solid tumors in Singapore.

Objective: To investigate social, clinical, and disease-related factors associated with diagnostic delay.

Materials And Methods: Two-hundred and 9 solid tumor cases reported to the Singapore Childhood Cancer Registry at KK Hospital between 1997 and 2007 were reviewed retrospectively. The natural logarithms of total delay times were correlated with social, clinical, and disease factors using univariate and multivariate analysis.

Appendicitis in immunosuppressed children: Still a diagnostic and therapeutic dilemma?

Acute appendicitis in the immunosuppressed patients are often difficult to diagnose and are associated with increased morbidity and mortality. Recent debates on primary appendicitis and typhlitis-associated appendicitis have contributed to the diagnostic and therapeutic dilemma. We retrospectively reviewed all our immunosuppressed patients with appendicitis.

"Chinese fan spread" distraction technique of laparoscopic reduction of intussusception.

Objective: The "Chinese Fan Spread" (CFS) distraction technique for laparoscopic reduction of intussusception is herein described and its outcome and benefits are evaluated.

Methods: A retrospective review was performed of all patients who underwent attempts at laparoscopic reduction of intussusception at our center. The CFS distraction technique was consistently applied in all cases.

Nonrhabdomyosarcoma soft tissue sarcoma (NRSTS).

Nonrhabdmyosarcoma soft tissue sarcoma (NRSTS) is a heterogenous group of tumors analyzed as a unique group because of the rarity of each histopathological subtype. Initial information available has been obtained from adult series or pediatric case studies. Recent reports by several multi-center groups have been published that evaluated prognostic factors and treatment protocols.

Laparoscopic-assisted transumbilical ovarian cystectomy in a neonate.

The occurrence of ovarian cysts in a neonate is common, but the management of the same is contentious. We present a case of a prenatally diagnosed complex ovarian cyst in a neonate, which was successfully treated by a novel laparoscopic technique. The literature was reviewed and the diagnosis, treatment options, and controversies in the management are discussed, highlighting the role of preservation of the ovary via the laparoscopic-assisted transumbilical ovarian cystectomy procedure.

Port-A-Cath insertions in acute leukaemia and childhood malignancies.

Objective: This retrospective case series sought to determine the incidence and profile of catheter-related complications associated with Port-A-Cath insertions in paediatric cancer patients, as well as predictive factors for infection-related port removals.

Methods: Between January 2002 and December 2004, 175 consecutive Port-A-Cath insertions were followed for a total of 75,000 days (median, 407; range, 6-1,074). Incidence of catheter-related bloodstream infections (CRBSIs), other complications and CRBSI-related port removals were analysed for cases with acute leukaemia versus other malignancies.

Port-A-Cath insertions in acute leukemia: does thrombocytopenia affect morbidity?

Background: Unnecessary delay of insertion of Port-A-Cath indwelling venous catheters in thrombocytopenic patients may result from fear of potential morbidity. This study sought to compare the morbidity of Port-A-Cath insertions in acute leukemic patients with platelet counts below and above 50 x 10(9)/L.

Method: Incidence and profile of catheter-related bloodstream infections (CRBSIs) and other complications were determined in 80 consecutive Port-A-Cath insertions in pediatric patients with acute leukemia from January 2002 to December 2004.

Acute suppurative thyroiditis in children secondary to pyriform sinus fistula.

Acute suppurative thyroiditis (AST), a potential complication of pyriform sinus fistula (PSF), is a rare clinical condition as the thyroid gland is remarkably resistant to infections. Lack of awareness of the entity contributes to the rarity and frustrating recurrences. We performed a retrospective review of all cases of AST due to PSF treated at our institution over a 10-year period.