Exploring the Limits of Robotic Surgery for Wilms Tumor: A Descriptive Analysis.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
Although open radical nephrectomy (ORN) remains the gold standard for the surgical treatment of Wilms tumor (WT), minimally invasive techniques may be used safely for selected cases. Their current development requires regular updates of surgical guidelines. We previously proposed preliminary criteria guiding robot-assisted radical nephrectomy (RARN) for WT, and, in light of our continued extensive experience, this study aimed to describe the selection of children for RARN, including a new volumetric ratio. All consecutive children who underwent ORN or RARN (2016-2023) for presumptive WT at our center were prospectively included. A volumetric ratio (preoperative tridimensional volumetry of [tumor + healthy kidney] over estimated patient's blood volume) was used to assess tumor volume. Surgical and oncological outcomes were compared between groups. Sixty radical nephrectomies were performed, including 23 RARNs (38%). No statistical difference was observed in oncological outcomes between the groups. RARN procedures in patients with a volumetric ratio <35% were performed without conversions, except for three cases with renal vein thrombus, midline crossing, and minor bleeding. Three children with a volumetric ratio <35% underwent ORN instead of RARN because of organizational issues. Approximately 40% of children in our highly selected cohort were eligible for RARN. In our experience, RARN was feasible for tumors with a volumetric ratio of <35% in the absence of renal vein thrombus, midline crossing, or adjacent-organ infiltration, with the need for external validation.