title: Laparoscopic nephrectomy for wilms tumor after chemotherapy: initial experience.
abstract: 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.
authors.affiliation: Department of Urology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Ricardo Jordão
authors.initials: RJ
authors.lastname: Duarte
authors.forename: Francisco Tibor
authors.initials: FT
authors.lastname: Dénes
authors.forename: Lilian Maria
authors.initials: LM
authors.lastname: Cristofani
authors.forename: Amilcar Martins
authors.initials: AM
authors.lastname: Giron
authors.forename: Vicente Odone
authors.initials: VO
authors.lastname: Filho
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
mesh_terms: 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*
chemical_list: D003609:Dactinomycin; D014750:Vincristine