Laparoscopic nephrectomy for wilms tumor after chemotherapy: initial experience.
OBJECTIVE
We describe 2 cases of laparoscopic nephrectomy for unilateral Wilms tumor in children who underwent preoperative chemotherapy.


METHODS
Two children with unilateral nonmetastatic Wilms tumor included in the International Society of Pediatric Oncology 2001 protocol were preoperatively treated with vincristine/actinomycin D and subsequently underwent laparoscopic nephrectomy and lymph node sampling. A 5 and 10 mm trocar transperitoneal approach was used in each case. The tumor was extracted without morcellation through a 4 cm Pffannensteil incision.


RESULTS
The 2 tumors were completely removed as well as lymph node samples. Intraoperative bleeding was minimal (50 ml). The postoperative period was free of complications and patients were discharged home after 3 days.


CONCLUSIONS
Laparoscopic nephrectomy for Wilms tumor is feasible in children after chemotherapy. It is a safe procedure and it allows the complete surgical approach required to treat this tumor. Longer followup is necessary to evaluate long-term results and more cases are necessary to compare the results of laparoscopic techniques with those of open surgical procedures.
Duarte
Ricardo Jordão
RJ
Department of Urology, University of São Paulo Medical School, São Paulo, Brazil.
Dénes
Francisco Tibor
FT
Cristofani
Lilian Maria
LM
Giron
Amilcar Martins
AM
Filho
Vicente Odone
VO
Arap
Sami
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000009:adverse effects; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D020360:Neoadjuvant Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*
D003609:Dactinomycin; D014750:Vincristine