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.
Written by:
Duarte RJ, Cristofani LM, Dénes FT, Filho VO, Tannuri U, Srougi M. Are you the author?
Department of Urology, University of São Paulo Medical School, São Paulo, Brazil; Department of Pediatric Oncology, University of São Paulo Medical School, São Paulo, Brazil.
Reference: Urology. 2014 Jul;84(1):191-5.
doi: 10.1016/j.urology.2014.02.026
PubMed Abstract
PMID: 24857277