Wilms tumor: a retrospective study of 32 patients using videolaparoscopic and open approaches

Urology. 2014 Jul;84(1):191-5. doi: 10.1016/j.urology.2014.02.026. Epub 2014 May 22.

Abstract

Objective: To compare videolaparoscopic nephrectomy and the open technique as treatments for Wilms tumor, specifically the surgical results, immediate and long-term complications, and patient survival.

Methods: A review of charts of children with unilateral Wilms tumor was performed. There were 2 surgical groups: (1) only open surgery and (2) videolaparoscopy. Complications, transfusion, ruptures, margins, conversions, lymph nodes, and relapse were analyzed.

Results: Seventeen children underwent laparoscopic nephrectomy and 15 underwent open nephrectomy. Mean surgical time was 164.71±26.07 minutes for the laparoscopic group, and there were no conversions or ruptures. The mean specimen weight was 145.01±105.85 g for the laparoscopic group and 257.40±162.70 g for the open surgery group. There was 1 preoperative rupture in the open surgery group. Transfusions were not required in either group. The surgical margins were positive in 1 of 17 cases (5.9%) in the laparoscopic group and in 3 of 15 cases (20%) in the open surgery group. One of the 17 (5.9%) laparoscopy-treated patients and 2 of the 15 open surgery-treated patients (13.3%) presented with local tumor relapse. The 5-year event-free survival rate was 93.3% (95% confidence interval, 0.61-0.99) for the laparoscopic group and 79.6% (95% confidence interval, 0.37-0.95] for the open surgery group (P=.446).

Conclusion: Both techniques showed similar immediate and long-term results.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Disease-Free Survival
  • Female
  • Humans
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / surgery*
  • Laparoscopy*
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects
  • Nephrectomy / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Survival Rate
  • Video-Assisted Surgery*
  • Wilms Tumor / mortality
  • Wilms Tumor / surgery*