Patient selection and technical aspects for laparoscopic nephrectomy in Wilms tumor.

摘要: Abstract Background Only limited data exist to define the role of laparoscopic nephrectomy for Wilms tumor. Our aim was present our experiences with this method special regard patient selection and technical aspects. Methods Records patients tumor who had been operated on using were reviewed retrospectively. Analyzed contained characteristics, outcome, staging, histology, size, lymph node sampling, pre- postoperative chemotherapy, radiotherapy, surgical procedures, complications. Results From 2010 2018 performed in 9 children (median age 24 months (12.0–57.5)) did not qualify nephron sparing surgery met internally defined criteria. Each received neoadjuvant chemotherapy which 7 tumors responded substantially. Median volume at surgery, maximal diameter, specimen weight 74 ml (15–207), 6.5 cm (3.5–9.3), 125 g (63–310), respectively. No intra- or complications occurred. Overall survival event-free 9/9, median follow up 48 (24–78). These used propose a algorithm. Technical aspects derived from experience include usage ureter as leading structure, transabdominal traction suture around ureter, sampling before nephrectomy. Conclusion With increasing expertise operating surgeons, more complex WT might be target minimally invasive provided that factors are carefully addressed.