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Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Pediatric Blood & Cancer Feb 22, 2020

Bouty A, Blanc T, Leclair MD, et al. - Researchers investigated the feasibility and outcomes of minimally invasive surgery (MIS) in Wilms tumor (WT) via conducting an international multicenter review of MIS total nephrectomies for WT between 2006 and 2018. They assessed 50 patients, with a median age of 38 months (6-181), receiving neoadjuvant chemotherapy, as per SIOP protocol, at 10 centers. Median tumor volume of 673 mL (18-3331) was estimated postchemotherapy; 16 tumors crossed the lateral border of the spine, and three crossed the midline. Conversion to an open approach was undertaken in six patients with tumors that crossed the lateral border of the spine (tumor volumes 1,560 mL [299-2,480]). Overall, completion of MIS was accomplished in 19% of the 195 nephrectomies for WT presenting during the study period. Outcomes support the feasibility of MIS in 20% of WT, with oncological outcomes similar to open surgery, no intraoperative rupture, and a low rate of local relapse. However, they recommend performing ongoing surveillance to evaluate this technique as it becomes widespread.
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