Laparoscopic Nephron-sparing Surgery for Metanephric Adenoma in Children: A Report of 2 Cases

Özden, Ender; Yağız, Beytullah; Ataç, Fatih; Çetin, Hasan; Bostanci, Yakup; Yakupoğlu, Yarkın Kamil; Sarıkaya, Şaban

doi:10.1016/j.urology.2015.03.034

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…The potential of laparoscopic nephron-sparing approach to renal tumours in children is highly uncertain, although the procedure is well accepted in adults; MIS in NSS could be an alternative approach however in a highly selected patient group. Improvement in identification of benign renal tumours, which were usually classified as or treated as malignant tumours, could potentially increase the number of patients eligible for minimally invasive partial nephrectomy (30). Open partial nephrectomy or laparoscopic radical nephrectomy should not compete, and current recommendations favours PN (7,14).…”

Section: Discussionmentioning

confidence: 99%

“…The recurrence rate was 2.7% in the SIOP-9 protocol (19) and 4.3% in the NWTS-4 protocol (18). Incomplete resection is an independent risk factor for local recurrence in WT (30).…”

Section: Laparoscopic Nephrectomy (Ln)mentioning

confidence: 98%

“…The largest tumour measured 67 mm in diameter. One re-attended on day 8 post-operatively, and required angiographic embolization for complication with pseudo aneurysm in the renal parenchyma (30).…”

Section: Nssmentioning

confidence: 99%

“…Proposed inclusion criteria include a small tumour that is well circumscribed, preferably with a polar location and without any vascular involvement or metastasis (30). Preoperative chemotherapy is commonly administered prior to NSS for WT, to reduce risk of tumour rupture.…”

Section: Nssmentioning

confidence: 99%

“…More than 50% of renal tissue should be spared in the surgery to give protection against hyper perfusion (14,16,28,30,41). Disadvantages for laparoscopic NSS in WT are tumour spillage, risk of peritoneal and port site metastasis, and surgical difficulties requiring high expertise and experienced surgeons (22,30). A problem occurs in case of positive surgical margins or neoplasm in sampled lymph nodes after NSS for WT, which would upstage the tumour and require more intensive adjuvant treatment.…”

Section: Nssmentioning

confidence: 99%

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Minimally invasive surgery in management of renal tumours in children

2017

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Minimally invasive surgery (MIS) in the management of malignant and benign renal tumours in children is gradually becoming more common. Experience is limited and restricted to case reports, retrospective chart reviews and a few cohort studies. There are currently no randomized controlled trials or controlled clinical trials comparing the laparoscopic and open surgical approach for the management of renal tumours in children. MIS may offer the same oncologic outcome in malignant renal tumours whilst providing the advantages associated with MIS in correctly selected cases. The technique for tumour resection has been shown to be feasible in regards to the recommended oncologic principles, although lymph node sampling can be inadequate in some cases. Preliminary reports do not show an increased risk of tumour rupture or inferior oncologic outcomes after MIS. However, the sample size remains small and duration of follow-up inadequate to draw any firm conclusions. Implementation of MIS is lacking in the protocols of the major study groups, and standardized recommendations for the indications and contra-indications remain undefined. The objective of this article is to present a review of the literature on the role of MIS in the management of renal tumours in children, with the main focus on Wilms' tumour (WT). Further studies on MIS in renal tumours are required to evaluate the incidence of oncological complications such as complete tumour resection and intra-operative tumour spillage. A long-term follow-up of patients managed by MIS is essential to compare recurrence rates and overall survival rates.

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Section: Discussionmentioning

confidence: 99%

“…The recurrence rate was 2.7% in the SIOP-9 protocol (19) and 4.3% in the NWTS-4 protocol (18). Incomplete resection is an independent risk factor for local recurrence in WT (30).…”

Section: Laparoscopic Nephrectomy (Ln)mentioning

confidence: 98%

Section: Nssmentioning

confidence: 99%

Section: Nssmentioning

confidence: 99%