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Yuan X, Liu X, Jing Q, Liu F, Zhang X. The application of full-size three-dimensional individual printed model combined with three-dimensional digital demonstration can facilitate patient's preoperative comprehension to robotic-assisted laparoscopic partial nephrectomy. Perioper Med (Lond) 2022; 11:22. [PMID: 35761307 PMCID: PMC9238097 DOI: 10.1186/s13741-022-00256-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this study, it was aimed to evaluate the feasibility and effectiveness of full-size three-dimensional individual printed model (3D-IPM) based on computerized tomography (CT) reconstruction combined with 3D individual digital models (3D-IDMs) for improving the patient's and their families' comprehension levels of robotic-assisted laparoscopic partial nephrectomy (RALPN) preoperatively. METHODS Between January 2020 and January 2021, 37 patients underwent RALPN in our institution. 3D individual digital models (3D-IDMs) were reconstructed based on the data of computerized tomography (CT) scanning and full-size 3D-IPMs were fabricated correspondingly. For each patient and his/her closest accompanying immediate family member (CAIFM) (spouse or son/daughter), two semi-structured conversations were held by using CT films (1st conversation) and 3D-IPM combined with 3D-IDM demonstration (2nd one) respectively. The preoperative levels of comprehension were evaluated quantitatively by using a self-made preoperative comprehending score (PCS) in the patients and CAIFMs. RESULTS All the fabrications of full-size 3D-IPMs and all the operations were technically successful. The total PCS elevated significantly by presenting 3D-IPM combined with 3D-IDM demonstration compared with CT films (42.5 vs 35.5 in patients, P < 0.001; 42.9 vs 35.8 in CAIFMs, P < 0.001). Sub-PCSs in the evaluating aspects of renal anatomy, mass characteristics, the upcoming RALPN procedure, potential complication risks, and prognosis also showed a uniformed climbing pattern with the assistance of 3D-IPM+3D-IDM. CONCLUSION The application of 3D-IPM presentation combined with 3D-IDM demonstration can improve the preoperative comprehension of patient and CAIFM to RALPN with more direct-viewing and verisimilar presentation, and can be used in RALPN patient education for increasing patients' and their families' cognitive empowerment.
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Affiliation(s)
- Xiaobin Yuan
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.,First College of Clinical Medicine, Shanxi Medical University, No. 56, Xinjiannan Road, Taiyuan, 030001, Shanxi, China
| | - Xiaolei Liu
- Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, Shanxi, China.,Third College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiang Jing
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.,First College of Clinical Medicine, Shanxi Medical University, No. 56, Xinjiannan Road, Taiyuan, 030001, Shanxi, China
| | - Fan Liu
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.,First College of Clinical Medicine, Shanxi Medical University, No. 56, Xinjiannan Road, Taiyuan, 030001, Shanxi, China
| | - Xuhui Zhang
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China. .,First College of Clinical Medicine, Shanxi Medical University, No. 56, Xinjiannan Road, Taiyuan, 030001, Shanxi, China.
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A Reliable Prediction Model for Renal Cell Carcinoma Subtype Based on Radiomic Features from 3D Multiphase Enhanced CT Images. JOURNAL OF ONCOLOGY 2021; 2021:6595212. [PMID: 34594377 PMCID: PMC8478553 DOI: 10.1155/2021/6595212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 12/04/2022]
Abstract
Background This study aimed to develop a prediction model to distinguish renal cell carcinoma (RCC) subtypes. Methods The radiomic features (RFs) from 5 different computed tomography (CT) phases were used in the prediction models: noncontrast phase (NCP), corticomedullary phase (CMP), nephrographic phase (NP), excretory phase (EP), and all-phase (ALL-P). Results For the ALL-P model, all of the RFs obtained from the 4 single-phase images were combined to 420 RFs. The ALL-P model performed the best of all models, with an accuracy of 0.80; the sensitivity and specificity for clear cell RCC (ccRCC) were 0.85 and 0.83; those for papillary RCC (pRCC) were 0.60 and 0.91; those for chromophobe RCC (cRCC) were 0.66 and 0.91, respectively. Binary classification experiments showed for distinguishing ccRCC vs. not-ccRCC that the area under the receiver operating characteristic curve (AUC) of the ALL-P and CMP models was 0.89, but the overall sensitivity/specificity/accuracy of the ALL-P model was better. For cRCC vs. non-cRCC, the ALL-P model had the best performance. Conclusions A reliable prediction model for RCC subtypes was constructed. The performance of the ALL-P prediction model was the best as compared to individual single-phase models and the traditional prediction model.
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Rosner MH, Jhaveri KD, McMahon BA, Perazella MA. Onconephrology: The intersections between the kidney and cancer. CA Cancer J Clin 2021; 71:47-77. [PMID: 32853404 DOI: 10.3322/caac.21636] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. This intersection takes many forms and includes drug-induced nephrotoxicity, electrolyte disorders, paraneoplastic glomerulonephritis, and the interactions of chronic kidney disease with cancer. Data clearly demonstrate that, when patients with cancer develop acute or chronic kidney disease, outcomes are inferior, and the promise of curative therapeutic regimens is lessened. This highlights the imperative for collaborative care between oncologists and nephrologists in recognizing and treating kidney disease in patients with cancer. In response to this need, specific training programs in onconephrology as well as dedicated onconephrology clinics have appeared. This comprehensive review covers many of the critical topics in onconephrology, with a focus on acute kidney injury, chronic kidney disease, drug-induced nephrotoxicity, kidney disease in stem cell transplantation, and electrolyte disorders in patients with cancer.
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Affiliation(s)
- Mitchell H Rosner
- Division of Nephrology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Kenar D Jhaveri
- Division of Kidney Disease and Hypertension, Zucker School of Medicine at Hofstra University, Great Neck, New York
| | - Blaithin A McMahon
- Division of Nephrology. Medical, University of South Carolina, Charleston, South Carolina
| | - Mark A Perazella
- Division of Nephrology, Yale University School of Medicine, New Haven, Connecticut
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Jiang Y, Zeng H, Zhu Z, Chen J, Chen H. Three-Dimensional Printing Assisted Laparoscopic Partial Nephrectomy vs. Conventional Nephrectomy in Patients With Complex Renal Tumor: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:551985. [PMID: 33194610 PMCID: PMC7643019 DOI: 10.3389/fonc.2020.551985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/27/2020] [Indexed: 01/20/2023] Open
Abstract
Objective: The purpose of this meta-analysis was to systematically assess the influence of three-dimensional (3D) printing technology in laparoscopic partial nephrectomy (LPN) of complex renal tumors. Methods: A systematic literature review was performed in June 2020 using the Web of Science, PubMed, Embase, the Cochrane library, the China National Knowledge Infrastructure (CNKI), and the Wanfang Databases to identify relevant studies. The data relative to operation time, warm ischemic time, intraoperative blood loss, positive surgical margin, reduction in estimated glomerular filtration rate (eGFR), and complications (including artery embolization, hematoma, urinary fistula, transfusion, hematuria, intraoperative bleeding, and fever) were extracted. Two reviewers independently assessed the quality of all included studies, and the eligible studies were included and analyzed using the Stata 12.1 software. A subgroup analysis was performed stratifying patients according to the complexity of the tumor and surgery type or to the nephrometry score. Results: One randomized controlled trial (RCT), two prospective controlled studies (PCS), and seven retrospective comparative studies (RCS) were analyzed, involving a total of 647 patients. Our meta-analysis showed that there were significant differences in operation time, warm ischemic time, intraoperative blood loss, reduction in eGFR, and complications between the LPN with 3D-preoperative assessment (LPN-3DPA) vs. LPN with conventional 2D preoperative assessment (LPN-C2DPA) groups. Positive surgical margin did not differ significantly. Conclusion: The LPN-3DPA group showed shorter operation time and warm ischemic time, as well as less intraoperative blood loss, reduction in eGFR, fewer complications for patients with complex renal tumor. Therefore, LPN assisted by three-dimensional printing technology should be a preferable treatment of complex renal tumor when compared with conventional LPN. However, further large-scale RCTs are needed in the future to confirm these findings.
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Affiliation(s)
| | | | | | - Jinbo Chen
- Xiangya Hospital, Central South University, Changsha, China
| | - Hequn Chen
- Xiangya Hospital, Central South University, Changsha, China
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Zhang X, Yan L, Yuan X, Bai T, Zhang L, Han S. Rapid exacerbation featuring acute leukemoid reaction after retrolaparoscopic nephrectomy: a rare case report of renal cell carcinoma with postoperative comprehensive genomic profiling. World J Surg Oncol 2020; 18:155. [PMID: 32631368 PMCID: PMC7339471 DOI: 10.1186/s12957-020-01926-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background Rapid lethal exacerbation and recurrence featuring acute leukemoid reaction (ALR) after retrolaparoscopic radical nephrectomy (RN) is a relatively rare clinical incident. Performing the reoperation for the patient and analyzing the tissue-based genetic mutation information postoperatively are a skill-demanding and meaningful task, which have been even more rarely reported. Case presentation We present a case with a large right renal mass (13.0 × 10.0 × 8.0 cm). This 71-year-old male patient underwent the retrolaparoscopic RN in our department. The operation was technically precise and successful with final pathological diagnosis of hybrid (clear cell and papillary type) renal cell carcinoma (RCC). However, 10 days after the patient was discharged, he was readmitted with the chief complaint of high fever with severe right flank pain. CT scanning revealed that right retroperitoneal hematoma and the blood routine showed the dramatic elevation of white blood cell count (WBC). Even though the immediate broad-spectrum antibiotics were administered without delay and subsequent percutaneous puncturing and drainage was performed, the patient’s condition still exacerbated rapidly. In spite of the reoperation of hematoma evacuation, the patient died of multiple organ failure 10 days after the reoperation. The pathological result of reoperation showed the necrotic and hematoma tissue blended with RCC tumor cells (nuclear grading III), and both of the postoperative tissue-originated comprehensive genomic profiling by using the specimens from the RN and reoperation respectively indicated significant mutations of some oncogenes which might have potential relevance with ALR. Besides, both of the immunohistochemical (IHC) staining results from primary surgical renal mass and reoperative resected tissue revealed the positive expressions of granulocyte colony-stimulating factor (G-CSF). Conclusions ALR may be a predictor of poor prognosis in patients with RCC, and comprehensive genomic profiling as well as the alterative expression of G-CSF can help to provide potential valuable genetic etiological information and evidence for guiding the potential effective molecular-targeting therapy.
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Affiliation(s)
- Xuhui Zhang
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China.
| | - Lijuan Yan
- Shanxi Cancer Institute, Shanxi Cancer Hospital, Taiyuan, 030000, Shanxi, China
| | - Xiaobin Yuan
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
| | - Tao Bai
- Department of Pathology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Lei Zhang
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
| | - Shuaihong Han
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
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Cortellini A, Buti S, Bersanelli M, Cannita K, Pinterpe G, Venditti O, Verna L, Porzio G, Natoli C, Tinari N, Cindolo L, Di Clemente L, Grassadonia A, De Tursi M, Ficorella C. Predictive Ability for Disease-Free Survival of the GRade, Age, Nodes, and Tumor (GRANT) Score in Patients with Resected Renal Cell Carcinoma. Curr Urol 2020; 14:98-104. [PMID: 32774235 PMCID: PMC7390980 DOI: 10.1159/000499252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recently, the GRANT (GRade, Age, Nodes, and Tumor) score was validated through an adjuvant trial population. METHODS This retrospective study evaluated the performance of the GRANT score as a prognostic model for disease-free survival (DFS), compared to the University of California Los Angeles Integrated Staging System (UISS) score, in a "real-life" population of early renal cell carcinoma patients. A uni-/multivariate analysis of DFS was also performed, to weigh the roles of baseline clinical factors. RESULTS From February 1998 to January 2018, 134 consecutive patients were enrolled, of which 85 patients (63.4%) had a favorable GRANT score, 49 (36.6%) an unfavorable GRANT score, and 21 (15.7%), 84 (62.6%), and 29 (21.6%) patients had a low, intermediate, or high risk of recurrence according to the UISS score, respectively. The median follow-up was 96 months. The median DFS of the overall study population was 53.7 months (95% CI: 38.4-87.8). Only bilateral renal cell carcinoma (p = 0.0041), Fuhrman grade 3/4 (p = 0.0008), pT3b- 4 (p = 0.0324), and pN1-2 (p = 0.0303) pathological status were confirmed as independent predictors of a shorter DFS by the multivariate analysis. The median DFS of patients with favorable and unfavorable GRANT scores were 84.9 (95% CI: 49.8-129) and 38.4 months (95% CI: 24.4-87.8), respectively, with a statistically significant difference (p = 0.0147). The median DFS of patients with low, intermediate, and high risk of recurrence according to the UISS score were 92.3 (95% CI: 18.1-153.9), 51.7 (95% CI: 36.2-87.8), and 49.8 months (95% CI: 31.3-129), respectively, without statistically significant differences (p = 0.4728). DFS c-statistic values were 0.59 (95% CI: 0.51-0.67) and 0.51 (95% CI: 0.42-0.60) for the GRANT and the UISS scores, respectively. CONCLUSION The GRANT score might be a useful tool that is user-friendly and easy to perform in clinical practice.
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Affiliation(s)
- Alessio Cortellini
- Medical Oncology Unit, St. Salvatore Hospital, L'Aquila
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila
| | | | | | - Katia Cannita
- Medical Oncology Unit, St. Salvatore Hospital, L'Aquila
| | | | - Olga Venditti
- Medical Oncology Unit, St. Salvatore Hospital, L'Aquila
| | - Lucilla Verna
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila
| | - Giampiero Porzio
- Medical Oncology Unit, St. Salvatore Hospital, L'Aquila
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila
| | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti
| | - Luca Cindolo
- Department of Urology, ASL 2 Abruzzo, Hospital “S. Pio da Pietrelcina”, Vasto
| | | | - Antonino Grassadonia
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti
| | - Corrado Ficorella
- Medical Oncology Unit, St. Salvatore Hospital, L'Aquila
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila
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Pietropaolo A, Jones P, Aboumarzouk OM, Rai BP, Lockyer CRW, Hayes MC, Geraghty R, Bhatnagar A, Somani BK. Trends in surgical and ablative treatment of localised renal cell carcinoma: A review of publication trends over 16 years (2000-2015). Arab J Urol 2019; 17:120-124. [PMID: 31285923 PMCID: PMC6600061 DOI: 10.1080/2090598x.2019.1590516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/25/2018] [Indexed: 11/04/2022] Open
Abstract
Objective: To investigate the bibliometric (publication) trends in surgical and ablative treatment of localised renal cell carcinoma (RCC) over a period of 16-years, from 2000 to 2015, as publication trends reflect clinical practice and new innovations. Material and methods: We performed a systematic review using PubMed over a 16-year period from 2000 to 2015 for all published papers on surgical and ablative management of renal tumours. Data were further analysed in two time periods, period-1 (2000–2007) and period-2 (2008–2015). Results: During the last 16 years a total of 2415 papers were published on surgical (n = 1662, 69%) and ablative (n = 753, 31%) management of RCC. This included partial nephrectomy (PN; n = 1662, 69%), cryoablation (CA; n = 405, 17%), and radiofrequency ablation (RFA; n = 348, 14%). When comparing the two time periods for PN, during period-2, the change was +189% (P < 0.001), +69% (P = 0.004) and +4600% (P < 0.001) for open PN, laparoscopic PN and robotic PN, respectively. Regarding ablative techniques, a change of +109% (P = 0.002) and +78% (P = 0.036) was seen for CA and RFA, respectively. There was also a significant rise in percutaneous CA when compared to laparoscopic CA (P < 0.002). Conclusions: There has been a rise in all forms of PN and ablative techniques over the last 16 years. This rise has been particularly steep for robotic PN potentially reflecting a change in surgical practice. Abbreviations: CA: cryoablation; CC: correlation coefficient; MIS: minimally invasive surgery/surgical; NSS: nephron-sparing surgery; (L)(O)(R)PN: (laparoscopic) (open) (robotic) partial nephrectomy; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RFA: radiofrequency ablation; RN: radical nephrectomy; SRM: small renal mass
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Affiliation(s)
- Amelia Pietropaolo
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Patrick Jones
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Bhavan P Rai
- Department of Urology, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - C Richard W Lockyer
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Matt C Hayes
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Rob Geraghty
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
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Abstract
Robot assistance has been rapidly adopted by urological surgeons and has become particularly popular for oncological procedures involving the retroperitoneal space. The wide dissemination of robot assistance probably reflects the limited amount of operating space available within the retroperitoneum and the advantages provided by robot-assisted approaches, including 3D imaging, wristed instrumentation and the shorter learning curve compared with that associated with the equivalent laparoscopic techniques. Surgical procedures that have traditionally been performed using an open or laparoscopic approach, such as partial nephrectomy, radical nephrectomy, retroperitoneal lymph node dissection, nephroureterectomy and adrenalectomy, are now often being performed using robot assistance. The frontiers of robot-assisted retroperitoneal oncological surgery are constantly expanding, with an emphasis on maintaining oncological and functional outcomes, while minimizing the level of surgical invasiveness.
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Liu X, Murphy MP, Xing W, Wu H, Zhang R, Sun H. Mitochondria-targeted antioxidant MitoQ reduced renal damage caused by ischemia-reperfusion injury in rodent kidneys: Longitudinal observations of T 2 -weighted imaging and dynamic contrast-enhanced MRI. Magn Reson Med 2017; 79:1559-1567. [PMID: 28608403 PMCID: PMC5811825 DOI: 10.1002/mrm.26772] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 04/09/2017] [Accepted: 05/09/2017] [Indexed: 12/14/2022]
Abstract
Purpose To investigate the effect of mitochondria‐targeted antioxidant MitoQ in reducing the severity of renal ischemia‐reperfusion injury (IRI) in rats using T2‐weighted imaging and dynamic contrast‐enhanced MRI (DCE‐MRI). Methods Ischemia‐reperfusion injury was induced by temporarily clamping the left renal artery. Rats were pretreated with MitoQ or saline. The MRI examination was performed before and after IRI (days 2, 5, 7, and 14). The T2‐weighted standardized signal intensity of the outer stripe of the outer medulla (OSOM) was measured. The unilateral renal clearance rate kcl was derived from DCE‐MRI. Histopathology was evaluated after the final MRI examination. Results The standardized signal intensity of the OSOM on IRI kidneys with MitoQ were lower than those with saline on days 5 and 7 (P = 0.004, P < 0.001, respectively). Kcl values of IRI kidneys with MitoQ were higher than those with saline at all time points (P = 0.002, P < 0.001, P = 0.001, P < 0.001). Histopathology showed that renal damage was the most predominant on the OSOM of IRI kidneys with saline, which was less obvious with MitoQ (P < 0.001). Conclusions These findings demonstrate that MitoQ can reduce the severity of renal damage in rodent IRI models using T2‐weighted imaging and DCE‐MRI. Magn Reson Med 79:1559–1667, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Xiaoge Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Michael P Murphy
- Medical Research Council Mitochondrial Biology Unit, Cambridge BioMedical Campus, Cambridge, UK
| | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, China
| | - Huanhuan Wu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Zhang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haoran Sun
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
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Affiliation(s)
- Mitchell H Rosner
- From the Division of Nephrology, University of Virginia Health System, Charlottesville (M.H.R.); and the Section of Nephrology, Yale University School of Medicine, New Haven, and the Veterans Affairs Medical Center, West Haven - both in Connecticut (M.A.P.)
| | - Mark A Perazella
- From the Division of Nephrology, University of Virginia Health System, Charlottesville (M.H.R.); and the Section of Nephrology, Yale University School of Medicine, New Haven, and the Veterans Affairs Medical Center, West Haven - both in Connecticut (M.A.P.)
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Eriksen KO, Johal NS, Mushtaq I. Minimally invasive surgery in management of renal tumours in children. Transl Pediatr 2016; 5:305-314. [PMID: 27867856 PMCID: PMC5107380 DOI: 10.21037/tp.2016.09.04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Minimally invasive surgery (MIS) in the management of malignant and benign renal tumours in children is gradually becoming more common. Experience is limited and restricted to case reports, retrospective chart reviews and a few cohort studies. There are currently no randomized controlled trials or controlled clinical trials comparing the laparoscopic and open surgical approach for the management of renal tumours in children. MIS may offer the same oncologic outcome in malignant renal tumours whilst providing the advantages associated with MIS in correctly selected cases. The technique for tumour resection has been shown to be feasible in regards to the recommended oncologic principles, although lymph node sampling can be inadequate in some cases. Preliminary reports do not show an increased risk of tumour rupture or inferior oncologic outcomes after MIS. However, the sample size remains small and duration of follow-up inadequate to draw any firm conclusions. Implementation of MIS is lacking in the protocols of the major study groups, and standardized recommendations for the indications and contra-indications remain undefined. The objective of this article is to present a review of the literature on the role of MIS in the management of renal tumours in children, with the main focus on Wilms' tumour (WT). Further studies on MIS in renal tumours are required to evaluate the incidence of oncological complications such as complete tumour resection and intra-operative tumour spillage. A long-term follow-up of patients managed by MIS is essential to compare recurrence rates and overall survival rates.
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Affiliation(s)
| | - Navroop Singh Johal
- Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Imran Mushtaq
- Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, UK
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