Robot-assisted radical nephrectomy for Wilms’ tumor in children
2023; Elsevier BV; Volume: 19; Issue: 4 Linguagem: Inglês
10.1016/j.jpurol.2023.04.016
ISSN1873-4898
AutoresJ. Van Der Jeugt, Caroline Jamaer, Camille Berquin, Karel Decaestecker, Piet Hoebeke, Erik Van Laecke, Charles Van Praet, Anne‐Françoise Spinoit,
Tópico(s)Urological Disorders and Treatments
ResumoSummary Introduction Surgical removal of the tumor is a key step in the management of nephroblastoma. Less invasive surgical approaches such as robot-assisted radical nephrectomy (RARN) has gained momentum over the past few years. This video presents a comprehensive step-by-step video for two cases: one uncomplicated left RARN and one more challenging right RARN. Materials & methods Following the UMBRELLA/SIOP protocol, both patients received neoadjuvant chemotherapy. Under general anesthesia, in a lateral decubitus position, four robotic and one assistant port are placed. After mobilization of the colon, the ureter and gonadal vessels are subsequently identified. The renal hilum is dissected, and the renal artery and vein are divided. The kidney is dissected with sparing of the adrenal gland. The ureter and gonadal vessels are divided, and the specimen is removed through a Pfannenstiel incision. Lymph node sampling is performed. Results Patients were 4 and 5 years old. The total surgical time was 95 and 200 min, with an estimated blood loss of 5 and 10 cc. The hospital stay was limited to 3 and 4 days. Both pathological reports confirmed the diagnosis of nephroblastoma, with tumour-free resection margins. No complications were observed 2 months postoperatively. Conclusion RARN is feasible in children.
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