Minimally invasive nephron-sparing surgery for unilateral Wilms tumor

Piché, Nelson; Barrieras, Diego

doi:10.1016/j.jpedsurg.2012.02.018

Cited by 30 publications

(9 citation statements)

References 18 publications

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“…Minimally invasive NSS for WTs has also been published, although at least one patient had diffuse peritoneal metastases following laparoscopic NSS [28][29][30].…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Current surgical standards of care in Wilms tumor

Kieran

Ehrlich

2016

Urologic Oncology: Seminars and Original Investigations

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“…Minimally invasive NSS for WTs has also been published, although at least one patient had diffuse peritoneal metastases following laparoscopic NSS [28][29][30].…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Current surgical standards of care in Wilms tumor

Kieran

Ehrlich

2016

Urologic Oncology: Seminars and Original Investigations

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“…NSS for unilateral WT has long been widely accepted in syndromic patients such as Denys–Drash, WAGR, and other WT1‐related diseases and more recently applied to any unilateral WT that fulfilled the criteria of the Umbrella protocol . In our experience, nephron‐sparing surgery is usually performed by a transperitoneal open approach.…”

Section: Discussionmentioning

confidence: 99%

“…NSS for unilateral WT has long been widely accepted in syndromic patients such as Denys-Drash, WAGR, and other WT1-related diseases [28][29][30] and more recently applied to any unilateral WT that fulfilled the criteria of the Umbrella protocol. 12 In our experience, The benefits of this technique compared with classic laparoscopy may come to light after many years, if they do at all; but the medico-economic study linked to our robotic program, which is currently running, will certainly help in evaluating cost-efficiency.…”

Section: Discussionmentioning

confidence: 99%

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Blanc

Pio

Clermidi

et al. 2019

Pediatric Blood & Cancer

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Aim We present the preliminary results of robotic‐assisted laparoscopic (RAL) total and partial nephrectomy for renal malignant tumors in children. Methods This is a prospective study of patients operated with RAL between December 2016 and September 2018. Patients with Wilms tumors were treated according to the SIOP‐2001 protocol. Patient and tumor characteristics, type of surgery, surgical‐related morbidity, and oncologic outcomes were recorded. Results were compared with a series of patients with similar age‐ and tumor‐related characteristics operated during the same period by an open surgical approach. Results Ten children underwent RAL nephrectomy with a mean age of five years (3.2–14.1 years). Total nephrectomy was done in six cases for Wilms tumor and in one case for renal sarcoma; three cases were converted. Complete removal of tumor without rupture was achieved in all cases. Postoperative course was uneventful, and patients were discharged between days 2 and 7. Neither recurrence nor medium‐term complications occurred. Nine patients are alive with a median follow‐up of 16 months (6–27 months) and one female died from complications of central nervous system metastases one year after surgery. When compared with the open surgical approach group, median tumor volume was smaller (P = 0.005), hospital stay was shorter (P = 0.01), and operative time was similar (P = 0.20). Conclusions RAL total and partial nephrectomy procedure for renal tumor in children may be an option in carefully selected cases. Indication should be discussed at tumor boards and surgery performed while adhering strictly to oncological surgical rules.

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“…LN in renal tumours in children is more commonly performed via the trans-abdominal approach (11,19,20), though cases are reported utilising the retroperitoneal approach (21,22). A systematic review and meta-analysis of available publications in the adult literature compared the outcomes of these two approaches and there were no differences in safety and efficacy of these two methods (23).…”

Section: Laparoscopic Nephrectomy (Ln)mentioning

confidence: 99%

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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Minimally invasive nephron-sparing surgery for unilateral Wilms tumor

Cited by 30 publications

References 18 publications

Current surgical standards of care in Wilms tumor

Current surgical standards of care in Wilms tumor

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Minimally invasive surgery in management of renal tumours in children

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