Peritoneal metastases after laparoscopic nephron-sparing surgery for localized Wilms tumor

Minimally invasive nephrectomy for Wilms tumors in children – data from SIOP 2001

“…Technical aspects of the operative approach must never be reason for compromises concerning the correct way of performing WT surgery. A thorough analysis of the role of MIS in WT surgery is mandatory, especially since there are already reports on the combined use with NSS, which underline further possible problems [33]. MIS for WT surgery is a challenging procedure requiring exceptional expertise by the operating surgeon.…”

Laparoscopic Nephron-sparing Surgery for Metanephric Adenoma in Children: A Report of 2 Cases

“…Peritoneal diffusion was described with peritoneal metastasis after laparoscopic NSS for WT. 9 However, in this report, the indication of NSS did not respect the usual protocols with MIS in a 10-cm upper pole tumor.…”

“…8 The major drawback of NSS in children is inadequate experience and the conventional conclusion that a positive surgical margin is an independent risk factor for local recurrence in WT. 9,10 Although positive surgical margin is a major concern, developing experience of NSS on other conditions and in other age groups has shown NSS as a safe and reasonable choice in selected renal tumors in children. 7 NSS in the treatment of renal masses in children has gained acceptance lately and the vast majority of experience comes from WT studies.…”

Minimally invasive nephron-sparing surgery for unilateral Wilms tumor

“…Tumor spillage, which is a potential risk of MIS and NSS, upstages the tumor to stage 3, with the consequence of necessary postoperative radiotherapy. A recent study reported on peritoneal seeding and local recurrence after laparoscopic NSS for localized WT in a 2-year-old child [20]. However, in that report, tumor size was 10 cm (which is significantly large relative to a 2-year-old child kidney), lymph node sampling was not performed at the initial surgery, it is unknown if a retrieval bag was used for tumor extraction, and chemotherapy was only given 6 weeks after surgery (no neoadjuvant chemotherapy).…”