Prechemotherapy Robotic-assisted Laparoscopic Radical Nephrectomy for an Adolescent With Wilms Tumor

Cost, Nicholas G.; Liss, Zachary; Bean, Cynthia; Geller, James I.; Minevich, Eugene; Noh, Paul H.

doi:10.1097/mph.0000000000000193

Cited by 21 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite these considerations, laparoscopic (both standard and robotic assisted) extirpation of renal units affected by WTs has been successfully performed in selected patients, both with and without prior treatment with chemotherapy [23][24][25][26][27]. Minimally invasive NSS for WTs has also been published, although at least one patient had diffuse peritoneal metastases following laparoscopic NSS [28][29][30].…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Current surgical standards of care in Wilms tumor

Kieran

Ehrlich

2016

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Current surgical standards of care in Wilms tumor

Kieran

Ehrlich

2016

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

“…In our cases, we found that using the robotic approach allowed for careful manipulation and resection of two particularly large masses. In the case of the nephrectomy, the robotic dexterity and magnification also facilitated pericaval node dissection which was an advantage reported by Cost et al in their case report of a pediatric robotic nephrectomy [12]. In regards to our adrenalectomy specimen, gross pathology demonstrated the mass abutting a thin rim of pseudocapsule, which is common for ganglioneuromas [25].…”

Section: Discussionmentioning

confidence: 70%

“…In the current literature, there are only four case reports of robotic techniques for cancers with pathology similar to adults in adolescent patients, namely renal cell carcinoma [10] and two non-seminomatous germ cell tumors [11], and one report of robotic nephrectomy being used safely for Wilms’ tumor in an adolescent patient [12]. The reasons for this are multifactorial: 1) genitourinary (GU) malignancies in pediatric patients are rare, making it difficult to amass case volume, 2) when they do occur, many are too large or complex for minimally invasive techniques, 3) the current management strategies for pediatric GU cancers are largely successful, therefore the incentive to test new management approaches is limited, and 4) a majority of pediatric GU oncology cases are managed by general surgeons [8,9] who generally have lower rates of robotic utilization than urologists.…”

Section: Introductionmentioning

confidence: 99%

Collaborating with our adult colleagues: A case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital

Varda

Cho

Wagner

et al. 2018

Journal of Pediatric Urology

View full text Add to dashboard Cite

Summary Background In adult urologic oncology the use of robotics has become commonplace; in pediatric urology it is rare. Herein, we describe a collaboration between an adult and a pediatric urologist performing robotic surgery for children and young adults with suspicious or cancerous genitourinary (GU) lesions. Objectives To evaluate clinical and oncologic outcomes in children and young adults undergoing robotic surgery for suspicious or cancerous lesions of the GU tract; to describe our collaborative model between an adult and pediatric surgeon at a free-standing children’s hospital. Design We retrospectively reviewed all robotic cases performed at our institution from 2014 to 2016 for patients with a GU malignancy or a suspicious mass. The surgeries were performed by a pediatric urologist with robotic experience and a fellowship-trained MIS adult urologist specializing in oncology. Perioperative and oncologic outcomes were recorded. Results A total of eight robotic cases were performed: four partial nephrectomies (PN) with retroperitoneal lymph node dissection (LND) (OT 269–338 min, EBL 5–300 mL, LOS 3–6 days), one adrenalectomy with LND (6.4 cm mass; OT 172 min, EBL 5 mL, LOS 3 days), one nephrectomy with pericaval LND (9.8 cm mass; 234 min, EBL 25 mL, LOS 3 days), and two retroperitoneal LNDs (OT 572 and 508 min, EBL 250 and 100, LOS 3 and 4 days). Patient weights ranged from 14 to 79 kg (mean 53.4 kg). There were no major complications (Clavien 3–5). Pathology results for PN included papillary RCC (AJCC pT1aNx) and two cases of segmental cystic renal dysplasia with nephrogenic rests. Bilateral template RPLNDs yielded paratesticular rhabdomyosarcoma (43 nodes; COG low risk group II stage I) and mixed non-seminomatous germ cell tumor (74 nodes; COG stage III). The nephrectomy yielded an undifferentiated sarcoma, low grade; the adrenalectomy favorable-type ganglioneuroma. Discussion In pediatrics, urologic oncology cases are often managed with open surgery. Our series demonstrates the feasibility of using the robotic approach in carefully selected cases. In doing so, the patient benefits from a minimally invasive surgery, while the surgeon benefits from robotic surgical dexterity. We seamlessly advanced these new techniques through a step-wise collaboration between an adult urologist who routinely performs robotic oncology procedures and a pediatric urologist experienced in robotics for benign conditions. Conclusion In this small series, we safely and effectively adapted adult robotic techniques for genitourinary oncology cases in children and young adults.

show abstract

“…The first applications of RAL for pediatric renal tumors were reported by Cost et al, who described in 2012 transperitoneal partial nephrectomy 20 and in 2014 a nephrectomy in an adolescent with WT. 21 To date, fewer than 10 cases of robotic management of renal tumors in children have been reported in the literature. 19,22 We report the early results of RAL total and partial nephrectomy in a high-volume pediatric reference center and show its feasibility while observing oncological surgical rules and careful patient selection.…”

Section: Indications Contraindicationsmentioning

confidence: 99%

“…A few case series had been reported since the first article of Meehan et al in 2013 with encouraging results. The first applications of RAL for pediatric renal tumors were reported by Cost et al, who described in 2012 transperitoneal partial nephrectomy and in 2014 a nephrectomy in an adolescent with WT . To date, fewer than 10 cases of robotic management of renal tumors in children have been reported in the literature …”

Section: Introductionmentioning

confidence: 99%

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Blanc

Pio

Clermidi

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Aim We present the preliminary results of robotic‐assisted laparoscopic (RAL) total and partial nephrectomy for renal malignant tumors in children. Methods This is a prospective study of patients operated with RAL between December 2016 and September 2018. Patients with Wilms tumors were treated according to the SIOP‐2001 protocol. Patient and tumor characteristics, type of surgery, surgical‐related morbidity, and oncologic outcomes were recorded. Results were compared with a series of patients with similar age‐ and tumor‐related characteristics operated during the same period by an open surgical approach. Results Ten children underwent RAL nephrectomy with a mean age of five years (3.2–14.1 years). Total nephrectomy was done in six cases for Wilms tumor and in one case for renal sarcoma; three cases were converted. Complete removal of tumor without rupture was achieved in all cases. Postoperative course was uneventful, and patients were discharged between days 2 and 7. Neither recurrence nor medium‐term complications occurred. Nine patients are alive with a median follow‐up of 16 months (6–27 months) and one female died from complications of central nervous system metastases one year after surgery. When compared with the open surgical approach group, median tumor volume was smaller (P = 0.005), hospital stay was shorter (P = 0.01), and operative time was similar (P = 0.20). Conclusions RAL total and partial nephrectomy procedure for renal tumor in children may be an option in carefully selected cases. Indication should be discussed at tumor boards and surgery performed while adhering strictly to oncological surgical rules.

show abstract

Prechemotherapy Robotic-assisted Laparoscopic Radical Nephrectomy for an Adolescent With Wilms Tumor

Cited by 21 publications

References 14 publications

Current surgical standards of care in Wilms tumor

Current surgical standards of care in Wilms tumor

Collaborating with our adult colleagues: A case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Contact Info

Product

Resources

About