title: Laparoscopic Radical Nephrectomy of Wilms' Tumor and Renal Cancer in Children: Preliminary Experience from a Two-Center Study in China.
abstract: BACKGROUND
  To report the preliminary experience of laparoscopic radical nephrectomy (LRN) in children with Wilms' tumor (WT) and renal cancer.
  
  
  METHODS
  From January 2010 to October 2013, the medical records of 7 cases of WT or renal cancer in children treated by LRN at two medical centers in China were reviewed.
  
  
  RESULTS
  All the patients were treated by LRN, and 3 of them underwent preoperative chemotherapy before surgery. The biggest tumor size was 10 cm without crossing the lateral edge of the vertebra at the time of operation. The median hospital stay was 8.5 days (range, 6-11 days). The pathologic investigation showed 5 cases of WT, 1 case of rhabdoid tumor, and 1 case of renal cell carcinoma. With a median follow-up of 1.9±1.5 years (range, 0.3-2.9 years), six children were in complete remission, and the remaining one was lost to follow-up. None of these patients presented evidence of oncological complications (tumoral recurrences, port-site implantation, or secondary lung metastases), and no small bowel obstruction occurred.
  
  
  CONCLUSIONS
  LRN for WT and renal cancer may be considered as an option in selected children. Preoperative chemotherapy is to decrease tumor size and to facilitate the dissection, avoiding tumor rupture. For trained laparoscopic surgeons, the eventual indication of LRN is the tumor not crossing the midline. A long follow-up and more cases are necessary to evaluate the results of the laparoscopic approach.
authors.affiliation: 1 Department of Pediatric Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University , Shanghai, China .
authors.forename: Jiang-Bin
authors.initials: JB
authors.lastname: Liu
authors.affiliation: 1 Department of Pediatric Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University , Shanghai, China .
authors.forename: Zhi-Bao
authors.initials: ZB
authors.lastname: Lu
authors.affiliation: 2 Department of Pediatric Surgery, Children's Hospital of Fudan University , Shanghai, China .
authors.forename: Xian-Min
authors.initials: XM
authors.lastname: Xiao
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002681:China; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D018335:Rhabdoid Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*