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Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion
PURPOSE: Bilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma. MATERIALS AND METHODS: In total, 9 cases of synchronous BWT were admitted t...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793901/ https://www.ncbi.nlm.nih.gov/pubmed/36582965 http://dx.doi.org/10.3389/fsurg.2022.1047975 |
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author | Gao, Pengfei Li, Jun Chen, Huadong Wu, Wenrui Liu, Longshan Jiang, Hong Xu, Lingling Wu, Chenglin Fu, Qian Liu, Juncheng Wang, Changxi |
author_facet | Gao, Pengfei Li, Jun Chen, Huadong Wu, Wenrui Liu, Longshan Jiang, Hong Xu, Lingling Wu, Chenglin Fu, Qian Liu, Juncheng Wang, Changxi |
author_sort | Gao, Pengfei |
collection | PubMed |
description | PURPOSE: Bilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma. MATERIALS AND METHODS: In total, 9 cases of synchronous BWT were admitted to our hospital between May 2016 to Aug 2020. We retrospectively reviewed the clinical data, surgical technique, and functional and oncological outcomes of these cases. RESULTS: The 9 cases included 3 males and 6 females, with a median age of 12 months at surgery (range 7–40). A total of 14 kidney units had renal sinus invasion (77.8%), whereas multifocal neoplasms were observed in 7 units (38.9%). The local stage distribution revealed 1 kidney with stage I, 10 kidneys with stage II, and 7 kidneys with stage III. Nephron-sparing surgery was performed on 15 kidney units (83.3%), among which 13 (72.2%) underwent bench surgery with autotransplantation (BS-AT), whereas 2 (11.1%) were subjected to tumor enucleation in vivo. Urinary leakage was the most prevalent postoperative complication. We observed negative margins. During the mean follow-up of 28.4 months, 2 patients (22.2%) succumbed from sepsis and renal failure, respectively, whereas the other 7 (77.8%) survived without recurrence. Survivors experienced an estimated glomerular filtration rate of 81 ± 15.4 ml/(min × 1.73 m(2)). The endpoint renal volume of 9 renal units receiving BS-AT significantly increased (P = 0.02). CONCLUSIONS: In summary, the surgical management of bilateral Wilms tumor requires meticulous operative approach and technique. Besides, BS-AT provides a viable alternative to nephron-sparing surgery for BWT patients with renal sinus invasion. |
format | Online Article Text |
id | pubmed-9793901 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97939012022-12-28 Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion Gao, Pengfei Li, Jun Chen, Huadong Wu, Wenrui Liu, Longshan Jiang, Hong Xu, Lingling Wu, Chenglin Fu, Qian Liu, Juncheng Wang, Changxi Front Surg Surgery PURPOSE: Bilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma. MATERIALS AND METHODS: In total, 9 cases of synchronous BWT were admitted to our hospital between May 2016 to Aug 2020. We retrospectively reviewed the clinical data, surgical technique, and functional and oncological outcomes of these cases. RESULTS: The 9 cases included 3 males and 6 females, with a median age of 12 months at surgery (range 7–40). A total of 14 kidney units had renal sinus invasion (77.8%), whereas multifocal neoplasms were observed in 7 units (38.9%). The local stage distribution revealed 1 kidney with stage I, 10 kidneys with stage II, and 7 kidneys with stage III. Nephron-sparing surgery was performed on 15 kidney units (83.3%), among which 13 (72.2%) underwent bench surgery with autotransplantation (BS-AT), whereas 2 (11.1%) were subjected to tumor enucleation in vivo. Urinary leakage was the most prevalent postoperative complication. We observed negative margins. During the mean follow-up of 28.4 months, 2 patients (22.2%) succumbed from sepsis and renal failure, respectively, whereas the other 7 (77.8%) survived without recurrence. Survivors experienced an estimated glomerular filtration rate of 81 ± 15.4 ml/(min × 1.73 m(2)). The endpoint renal volume of 9 renal units receiving BS-AT significantly increased (P = 0.02). CONCLUSIONS: In summary, the surgical management of bilateral Wilms tumor requires meticulous operative approach and technique. Besides, BS-AT provides a viable alternative to nephron-sparing surgery for BWT patients with renal sinus invasion. Frontiers Media S.A. 2022-12-13 /pmc/articles/PMC9793901/ /pubmed/36582965 http://dx.doi.org/10.3389/fsurg.2022.1047975 Text en © 2022 Gao, Li, Chen, Wu, Liu, Jiang, Xu, Wu, Fu, Liu and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Gao, Pengfei Li, Jun Chen, Huadong Wu, Wenrui Liu, Longshan Jiang, Hong Xu, Lingling Wu, Chenglin Fu, Qian Liu, Juncheng Wang, Changxi Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title_full | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title_fullStr | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title_full_unstemmed | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title_short | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
title_sort | bench surgery with autotransplantation for bilateral wilms tumor—a feasible technique for renal sinus invasion |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793901/ https://www.ncbi.nlm.nih.gov/pubmed/36582965 http://dx.doi.org/10.3389/fsurg.2022.1047975 |
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