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Murine Bilateral Renal Lymphadenectomy
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Nephron-sparing partial nephrectomy for bilateral Wilms' tumor.

Jason Sulkowski1, Thomas Kolon, Peter Mattei

  • 1Division of Pediatric General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

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Summary

Nephron-sparing partial nephrectomy is a safe and effective treatment for children with bilateral Wilms' tumor (BWT) or recurrence, preserving kidney function and preventing tumor relapse.

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Area of Science:

  • Pediatric Oncology
  • Surgical Nephrology

Background:

  • Partial nephrectomy is increasingly utilized for pediatric bilateral Wilms' tumor (BWT) and contralateral recurrence.
  • Nephron-sparing surgery aims to maximize tumor removal while preserving functional kidney tissue.
  • Prior studies indicated significant complication, recurrence, and mortality rates associated with these procedures.

Purpose of the Study:

  • To evaluate the safety and efficacy of nephron-sparing partial nephrectomy in pediatric patients with BWT or contralateral recurrence.
  • To assess complications, recurrence rates, postoperative renal function, and survival outcomes.

Main Methods:

  • Retrospective review of 12 pediatric patients (aged 9-42 months) with BWT or contralateral recurrence who underwent partial nephrectomy.
  • Analysis of preoperative imaging, operative details, pathology reports, and patient outcomes.
  • Key outcomes included complications, recurrence, readmissions, and glomerular filtration rate (GFR).

Main Results:

  • All 12 patients successfully underwent nephron-sparing resection; only 2 required unilateral nephrectomy.
  • Median length of stay was 3 days, with no major complications or urine leaks.
  • Ten patients followed for a median of 36 months showed no recurrences or readmissions, with mean GFR of 107.7 mL/min/1.73 m(2).

Conclusions:

  • Nephron-sparing resection is a safe and effective approach for pediatric BWT or contralateral recurrence.
  • This technique should be integrated into the multimodal treatment strategy for these conditions.
  • The study demonstrates successful preservation of renal function and oncologic control.