What is the role of laparoscopic nephrectomy in the treatment of Wilms tumor?

Updated: Feb 01, 2019
  • Author: Tunc Ozan, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Answer

Laparoscopy has been used for 15 years in pediatric surgical oncology. [6, 7, 8, 9] More recently, several authors have recommended the use of a laparoscopic approach in children with Wilms tumor that has favorable histology and has not spread locally or metastasized. [10, 11] A complete surgical procedure can be performed by laparoscopy when the tumor is small, allowing a first approach to the renal vessels without mobilization of the kidney. In some reports, all the procedures could be completed when the tumor did not cross the lateral edge of the vertebra on the CT scan. [12, 13]

In addition, preliminary but encouraging data indicate that a laparoscopic approach to nephrectomy in benign disease is associated with decreased lengths of hospital stay and analgesic requirements in the pediatric patient. [14, 15, 16, 17] In a child with cancer, faster recovery with a laparoscopic procedure would offer the further benefit of reducing the time required to begin or reinstitute chemo- or radiotherapy postoperatively. [18]


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