Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion
PurposeBilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma.Materials and methodsIn total, 9 cases of synchronous BWT were admitted to our...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1047975/full |
| _version_ | 1811293630607917056 |
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| author | Pengfei Gao Pengfei Gao Jun Li Huadong Chen Wenrui Wu Longshan Liu Hong Jiang Lingling Xu Chenglin Wu Qian Fu Juncheng Liu Changxi Wang Changxi Wang Changxi Wang |
| author_facet | Pengfei Gao Pengfei Gao Jun Li Huadong Chen Wenrui Wu Longshan Liu Hong Jiang Lingling Xu Chenglin Wu Qian Fu Juncheng Liu Changxi Wang Changxi Wang Changxi Wang |
| author_sort | Pengfei Gao |
| collection | DOAJ |
| description | PurposeBilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma.Materials and methodsIn total, 9 cases of synchronous BWT were admitted to our hospital between May 2016 to Aug 2020. We retrospectively reviewed the clinical data, surgical technique, and functional and oncological outcomes of these cases.ResultsThe 9 cases included 3 males and 6 females, with a median age of 12 months at surgery (range 7–40). A total of 14 kidney units had renal sinus invasion (77.8%), whereas multifocal neoplasms were observed in 7 units (38.9%). The local stage distribution revealed 1 kidney with stage I, 10 kidneys with stage II, and 7 kidneys with stage III. Nephron-sparing surgery was performed on 15 kidney units (83.3%), among which 13 (72.2%) underwent bench surgery with autotransplantation (BS-AT), whereas 2 (11.1%) were subjected to tumor enucleation in vivo. Urinary leakage was the most prevalent postoperative complication. We observed negative margins. During the mean follow-up of 28.4 months, 2 patients (22.2%) succumbed from sepsis and renal failure, respectively, whereas the other 7 (77.8%) survived without recurrence. Survivors experienced an estimated glomerular filtration rate of 81 ± 15.4 ml/(min × 1.73 m2). The endpoint renal volume of 9 renal units receiving BS-AT significantly increased (P = 0.02).ConclusionsIn summary, the surgical management of bilateral Wilms tumor requires meticulous operative approach and technique. Besides, BS-AT provides a viable alternative to nephron-sparing surgery for BWT patients with renal sinus invasion. |
| first_indexed | 2024-04-13T05:04:20Z |
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| id | doaj.art-422935b5128149eda2fcf63b4c4a31e7 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-13T05:04:20Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-422935b5128149eda2fcf63b4c4a31e72022-12-22T03:01:13ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-12-01910.3389/fsurg.2022.10479751047975Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasionPengfei Gao0Pengfei Gao1Jun Li2Huadong Chen3Wenrui Wu4Longshan Liu5Hong Jiang6Lingling Xu7Chenglin Wu8Qian Fu9Juncheng Liu10Changxi Wang11Changxi Wang12Changxi Wang13Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaPediatric Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaPurposeBilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma.Materials and methodsIn total, 9 cases of synchronous BWT were admitted to our hospital between May 2016 to Aug 2020. We retrospectively reviewed the clinical data, surgical technique, and functional and oncological outcomes of these cases.ResultsThe 9 cases included 3 males and 6 females, with a median age of 12 months at surgery (range 7–40). A total of 14 kidney units had renal sinus invasion (77.8%), whereas multifocal neoplasms were observed in 7 units (38.9%). The local stage distribution revealed 1 kidney with stage I, 10 kidneys with stage II, and 7 kidneys with stage III. Nephron-sparing surgery was performed on 15 kidney units (83.3%), among which 13 (72.2%) underwent bench surgery with autotransplantation (BS-AT), whereas 2 (11.1%) were subjected to tumor enucleation in vivo. Urinary leakage was the most prevalent postoperative complication. We observed negative margins. During the mean follow-up of 28.4 months, 2 patients (22.2%) succumbed from sepsis and renal failure, respectively, whereas the other 7 (77.8%) survived without recurrence. Survivors experienced an estimated glomerular filtration rate of 81 ± 15.4 ml/(min × 1.73 m2). The endpoint renal volume of 9 renal units receiving BS-AT significantly increased (P = 0.02).ConclusionsIn summary, the surgical management of bilateral Wilms tumor requires meticulous operative approach and technique. Besides, BS-AT provides a viable alternative to nephron-sparing surgery for BWT patients with renal sinus invasion.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1047975/fullbilateral Wilms tumorbench surgeryautotransplantation (AT)nephron-sparing surgery (NSS)renal sinus invasion |
| spellingShingle | Pengfei Gao Pengfei Gao Jun Li Huadong Chen Wenrui Wu Longshan Liu Hong Jiang Lingling Xu Chenglin Wu Qian Fu Juncheng Liu Changxi Wang Changxi Wang Changxi Wang Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion Frontiers in Surgery bilateral Wilms tumor bench surgery autotransplantation (AT) nephron-sparing surgery (NSS) renal sinus invasion |
| title | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
| title_full | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
| title_fullStr | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
| title_full_unstemmed | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
| title_short | Bench surgery with autotransplantation for bilateral Wilms tumor—A feasible technique for renal sinus invasion |
| title_sort | bench surgery with autotransplantation for bilateral wilms tumor a feasible technique for renal sinus invasion |
| topic | bilateral Wilms tumor bench surgery autotransplantation (AT) nephron-sparing surgery (NSS) renal sinus invasion |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1047975/full |
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