title: Laparoscopic treatment of renal cancer in children: a multicentric study and review of oncologic and surgical complications.
abstract: OBJECTIVE
  The aim was to report a multicentric study with a longer follow-up to evaluate the laparoscopic radical nephrectomy in children with renal cancer.
  
  
  METHODS
  This was a retrospective multicentric study, from October 2005 to January 2012, of children who underwent a laparoscopic radical nephrectomy for small renal malignant tumors.
  
  
  RESULTS
  Seventeen children were included in this study. Sixteen underwent chemotherapy before surgery according the SIOP (Société Internationale d'Oncologie Pédiatrique) protocol and one was treated by surgery only for a carcinoma. All except one could be treated by laparoscopy; the biggest tumoral size was 8 cm. The median hospital stay was 3 days (2-10). The pathologic examination showed 15 Wilms' tumors, one clear cell sarcoma and one TFE3 renal cell carcinoma. With a median follow-up of 42 months (range 12 and 77 months) after laparoscopic radical nephrectomy, 15 children had no oncological complications (port site or local recurrence, pulmonary metastasis) and one had a local recurrence without intraoperative tumoral rupture. The child with TFE3 renal cell carcinoma died 4 years after surgery from brain and lung metastases without local recurrence. No small bowel obstruction occurred.
  
  
  CONCLUSIONS
  Radical nephrectomy in children for Wilms' tumor or other renal cancer can be safely performed laparoscopically and our indications can be summarized, for trained laparoscopic surgeons, by small tumors under about 8 cm diameter, especially without crossing the lateral edge of the vertebra on the CT scan at the time of surgery.
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Nord, Saint-Etienne, France. Electronic address: francois.varlet@chu-st-etienne.fr.
authors: François
authors: F
authors: Varlet
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Caen, France.
authors: Thierry
authors: T
authors: Petit
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Mere enfant, Nantes, France.
authors: Marc-David
authors: MD
authors: Leclair
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Clocheville, Tours Cedex, France.
authors: Hubert
authors: H
authors: Lardy
authors: Department of Pediatric Surgery, Centre Hospitalier, Centre de la mere et de l'enfant Le Parc, Colmar, France.
authors: Stephan
authors: S
authors: Geiss
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Hautepierre, Strasbourg, France.
authors: François
authors: F
authors: Becmeur
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Caen, France.
authors: Philippe
authors: P
authors: Ravasse
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Caen, France.
authors: Julien
authors: J
authors: Rod
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Clocheville, Tours Cedex, France.
authors: Guénolée
authors: G
authors: de Lambert
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Clocheville, Tours Cedex, France.
authors: Karim
authors: K
authors: Braik
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Nord, Saint-Etienne, France.
authors: Florence
authors: F
authors: Lardellier-Reynaud
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Nord, Saint-Etienne, France.
authors: Manuel
authors: M
authors: Lopez
mesh_terms: D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*
keywords: Child; Complications; Laparoscopy; Renal cancer; Wilms' tumor