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Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor

INTRODUCTION: The place of laparoscopy in the resection of Wilms’ tumors has remained debatable, but evidence that neoadjuvant chemotherapy causes tumor shrinkage has made laparoscopic nephrectomy (LN) a feasible option. Laparoscopic nephron-sparing surgery (NSS) is technically very demanding and se...

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Autores principales: Murawski, Maciej, Stefanowicz, Joanna, Łosin, Marcin, Gołębiewski, Andrzej, Czauderna, Piotr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481445/
https://www.ncbi.nlm.nih.gov/pubmed/37680728
http://dx.doi.org/10.5114/wiitm.2022.123115
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author Murawski, Maciej
Stefanowicz, Joanna
Łosin, Marcin
Gołębiewski, Andrzej
Czauderna, Piotr
author_facet Murawski, Maciej
Stefanowicz, Joanna
Łosin, Marcin
Gołębiewski, Andrzej
Czauderna, Piotr
author_sort Murawski, Maciej
collection PubMed
description INTRODUCTION: The place of laparoscopy in the resection of Wilms’ tumors has remained debatable, but evidence that neoadjuvant chemotherapy causes tumor shrinkage has made laparoscopic nephrectomy (LN) a feasible option. Laparoscopic nephron-sparing surgery (NSS) is technically very demanding and seems to be feasible and effective only when performed by a very experienced surgeon. AIM: We report 7 cases of laparoscopic nephrectomy and 1 case of laparoscopic heminephrectomy for Wilms’ tumor. MATERIAL AND METHODS: Forty-two consecutive children with primary renal tumor underwent nephrectomy between 2013 and 2020; 11 had an LN. Among them there were 8 children with Wilms’ tumor, with age between 13 months and 7 years. All patients received neoadjuvant chemotherapy according to the current SIOP protocol. The mean tumor volume before and after chemotherapy was 174.4 ml (range: 14.7–501) and 32.8 ml (range: 4.3–68) respectively. RESULTS: Seven laparoscopic nephrectomies and one heminephrectomy were performed. No patient had an intraoperative tumor rupture. All children had an attempt of lymph node sampling (their number per pathology assessment was in the range 0–5). There were no intraoperative events. One complication after heminephrectomy occurred, which was urine leak. Five patients had stage I tumor and 3 had stage II. Seven patients had an intermediate-risk and one had a high-risk tumor. There were no local or distant relapses. All patients remained disease-free at a median follow-up of 71 months (range: 16–94). CONCLUSIONS: This report demonstrates the feasibility of LN in children with Wilms’ tumors. The patients should be carefully selected and specific training in laparoscopy is necessary, particularly with regard to laparoscopic heminephrectomy.
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spelling pubmed-104814452023-09-07 Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor Murawski, Maciej Stefanowicz, Joanna Łosin, Marcin Gołębiewski, Andrzej Czauderna, Piotr Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: The place of laparoscopy in the resection of Wilms’ tumors has remained debatable, but evidence that neoadjuvant chemotherapy causes tumor shrinkage has made laparoscopic nephrectomy (LN) a feasible option. Laparoscopic nephron-sparing surgery (NSS) is technically very demanding and seems to be feasible and effective only when performed by a very experienced surgeon. AIM: We report 7 cases of laparoscopic nephrectomy and 1 case of laparoscopic heminephrectomy for Wilms’ tumor. MATERIAL AND METHODS: Forty-two consecutive children with primary renal tumor underwent nephrectomy between 2013 and 2020; 11 had an LN. Among them there were 8 children with Wilms’ tumor, with age between 13 months and 7 years. All patients received neoadjuvant chemotherapy according to the current SIOP protocol. The mean tumor volume before and after chemotherapy was 174.4 ml (range: 14.7–501) and 32.8 ml (range: 4.3–68) respectively. RESULTS: Seven laparoscopic nephrectomies and one heminephrectomy were performed. No patient had an intraoperative tumor rupture. All children had an attempt of lymph node sampling (their number per pathology assessment was in the range 0–5). There were no intraoperative events. One complication after heminephrectomy occurred, which was urine leak. Five patients had stage I tumor and 3 had stage II. Seven patients had an intermediate-risk and one had a high-risk tumor. There were no local or distant relapses. All patients remained disease-free at a median follow-up of 71 months (range: 16–94). CONCLUSIONS: This report demonstrates the feasibility of LN in children with Wilms’ tumors. The patients should be carefully selected and specific training in laparoscopy is necessary, particularly with regard to laparoscopic heminephrectomy. Termedia Publishing House 2022-12-17 2023-06 /pmc/articles/PMC10481445/ /pubmed/37680728 http://dx.doi.org/10.5114/wiitm.2022.123115 Text en Copyright © 2023 Sekcja Wideochirurgii TChP https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) )
spellingShingle Original Paper
Murawski, Maciej
Stefanowicz, Joanna
Łosin, Marcin
Gołębiewski, Andrzej
Czauderna, Piotr
Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title_full Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title_fullStr Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title_full_unstemmed Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title_short Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
title_sort laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for wilms’ tumor
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481445/
https://www.ncbi.nlm.nih.gov/pubmed/37680728
http://dx.doi.org/10.5114/wiitm.2022.123115
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