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Surgery can be used both to help diagnose neuroblastoma and to treat it. For smaller tumors that have not spread, surgery is often the only treatment that is needed.  

Surgical (open) biopsy

In many cases, doctors need to get a sample of the tumor to be sure it is a neuroblastoma before deciding which treatment might work best. Tumor samples can be removed during a surgical biopsy to be looked at under a microscope and for other lab tests.

If the tumor is in the abdomen (belly), the surgeon might do the biopsy with a laparoscope. This is a long, thin tube with a tiny video camera on the end. It is put into the abdomen through a small incision to allow the surgeon to see inside. The surgeon then makes a second small incision to reach inside the abdomen with long, thin instruments and remove pieces of the tumor.

Surgery to treat neuroblastoma

After neuroblastoma is diagnosed, surgery is often used to try to remove as much of the tumor as possible. In some cases, surgery can remove all (or almost all) of the tumor, and no additional treatments are needed.

During the operation, the surgeon looks carefully for signs of cancer spread to other organs. Nearby lymph nodes (small collections of immune system cells to which cancers often spread first) are removed and looked at under a microscope for cancer cells.

If possible, the surgeon will remove the entire tumor. This is less likely if the tumor is near vital structures or wrapped around large blood vessels. Even if some of the tumor is left behind, that doesn't always mean the tumor will come back. Whether chemotherapy or other treatments will be needed after surgery depends on the child's risk group.

If the tumor is very large, chemotherapy may be used before surgery to shrink the tumor and make it easier to remove.

Possible risks and side effects of surgery

The risks from surgery depend on the location of the tumor and the extent of the operation, as well as the child’s health beforehand. Serious complications, although rare, can include problems with anesthesia; excess bleeding; infections; and damage to blood vessels, kidneys or other organs, or nerves. Complications are more likely if the tumor is large and growing into blood vessels or nerves. Most children will have some pain for a while after the operation, but this can usually be helped with medicines if needed.