Surgical Aspects in the Treatment of Patients With Unilateral Wilms Tumor

Fuchs, Joerg; Kienecker, Katarina; Furtwängler, Rhoikos; Warmann, Steven W.; Bürger, D.; Thürhoff, Joachim W.; Hager, J.; Graf, Norbert

doi:10.1097/sla.0b013e31819ed92b

Cited by 65 publications

(25 citation statements)

References 13 publications

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“…Therefore, when spillage is encountered, it is a criterion for Stage III designation with the inevitable need for adjuvant intensive chemotherapy and oftentimes also radiotherapy. [1112] Nevertheless, the reported spillage rates range between 15.3% and 22% according to NWTSG and 2.2% and 3.2% according to SIOP,[10111314] probably due to a higher number of NWTS Stage III patients treated initially with surgery (30.4% vs. 14.2%; P < 0.0001) as well as the fact that primary chemotherapy leads to shrinkage of the tumor and makes it firmer. In accordance, Barber et al .,[15] reviewing their database composed from 41 children, identified 6 cases (15%) with intraoperative tumor spills, of which 3 were Stage III disease and 3 were Stage IV.…”

Section: Discussionmentioning

confidence: 99%

Nephrectomy in children with wilms' tumor: 15 years of experience with “Tumor Delivery Technique”

Mor

Zilberman

Morag

et al. 2018

Afr J Paediatr Surg

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Background:The contemporary surgical approach to Wilms' tumors follows that used in adults with renal cell carcinomas, namely, early occlusion of the renal vessels and then removal of the kidney as an intact mass. For years, the surgical approach at our institution has been different, starting with blunt separation of the kidney from the surrounding tissues, followed by its delivery outside the abdominal cavity while it is only attached to the major blood vessels which are subsequently ligated. We aimed to present this “tumor delivery technique” and evaluate its outcomes.Materials and Methods:We retrospectively reviewed medical records of children who underwent nephrectomy for Wilms' tumor using “tumor delivery technique.” All procedures were performed by the same team, according to the same surgical principles.Results:Between 2000 and 2015, 36 children were operated. Median age was 31 months (interquartile range [IQR]: 6–45 mo), and median maximal tumor diameter was 10 cm (IQR: 8–13.9 cm). Tumors were located to the right side in 47%, left side in 42%, and bilateral in 11%. Twelve children have received preoperative neoadjuvant chemotherapy. Capsular disruption and tumor spillage were documented in 4 cases (11%).Conclusions:“Tumor delivery technique” is an easy and safe approach which might reduce the overall complication rates and the incidence of intraoperative tumor spillage.

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Section: Discussionmentioning

confidence: 99%

Nephrectomy in children with wilms' tumor: 15 years of experience with “Tumor Delivery Technique”

Mor

Zilberman

Morag

et al. 2018

Afr J Paediatr Surg

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“…A radical nephrectomy with lymph node sampling is the “gold standard” surgical protocol for unilateral WT [ 9 – 11 ]. However, retroperitoneal surgery such as nephrectomy might injure the anomalous venous structures that are in fact typically thin walled, dilated and tortuous [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Wilms tumor with inferior vena cava duplication: a rare case report

Guo

Liu

et al. 2018

BMC Urol

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BackgroundWilms tumor is the most common renal tumor of childhood. Duplication of the inferior vena cava is an uncommon anomaly. In the present study, we present a case of Wilms tumor with the inferior vena cava duplication, which has not been reported previously.Case presentationA 14-month-old female presented with an enlarging abdominal mass. Computed tomography imaging demonstrated a large mass in the right kidney, duplication of the inferior vena cava below the renal veins and compression of the right inferior vena cava caused by the enormous mass. A right radical nephrectomy was performed. Final pathology was consistent with Wilms tumor. Postoperative adjuvant chemotherapy was executed. Computed tomography imaging at 3 months postoperatively showed the right inferior vena cava played a dominant role and the left inferior vena cava was not detected clearly. During the follow-up of 18 months, no local recurrence or metastasis has been observed.ConclusionIt is important to recognize the case of Wilms tumor with the inferior vena cava duplication to avoid injury of retroperitoneal venous anomalies and life-threatening hemorrhage during surgery through preoperative computed tomography.Electronic supplementary materialThe online version of this article (10.1186/s12894-018-0401-0) contains supplementary material, which is available to authorized users.

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“…Together with the complete removal of all neoplastic compounds, a sufficient lymph node sampling is a main goal of surgical treatment in affected children (47, 48). Laparoscopy is increasingly used for tumor nephrectomy in nephroblastoma patients (49, 50), however, a systematical analysis from a multicenter trial has been lacking for a long time.…”

Section: Abdominal Tumorsmentioning

confidence: 99%

Minimally Invasive Surgery for Pediatric Tumors â€“ Current State of the Art

et al. 2014

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During recent years, minimally invasive surgery (MIS) has become the standard approach for various operations in infants and children. This also holds true for surgery in children with solid tumors. Meanwhile, more and more oncological biopsies and resections are being performed laparoscopically or thoracoscopically. Despite its increasing role in pediatric tumor surgery, the different national and international multicenter trial groups have not yet implemented MIS within guidelines and recommendations in most of the current treatment protocols. An increasing number of reports describe a potential role of MIS in the different entities of pediatric surgical oncology. Over the time, there has been a diverse development of this approach with regard to the different neoplasms. The aim of this article is to give an overview and to describe the current state of the art of MIS in pediatric solid tumors.

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Surgical Aspects in the Treatment of Patients With Unilateral Wilms Tumor

Cited by 65 publications

References 13 publications

Nephrectomy in children with wilms' tumor: 15 years of experience with “Tumor Delivery Technique”

Nephrectomy in children with wilms' tumor: 15 years of experience with “Tumor Delivery Technique”

Wilms tumor with inferior vena cava duplication: a rare case report

Minimally Invasive Surgery for Pediatric Tumors â€“ Current State of the Art

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