112 / 238
112
29
th
CONGRESS OF THE ESPU
08:32–08:35
S13-7 (PP)
DO IMAGE-DEFINED RISK FACTORS RELIABLY PREDICT
THE RISK OF ASSOCIATED NEPHRECTOMY IN ABDOMINAL
NEUROBLASTOMA SURGERY?
Sebastien FARAJ
1
, Estelle THEBAUD
2
, Marie Pierre QUERE
3
, Stephanie PROUST
4
,
Isabelle PELLIER
4
and Marc David LECLAIR
1
1) CHU Nantes, Pediatric Surgery, Nantes, FRANCE - 2) CHU Nantes, Pediatric Oncology, Nantes, FRANCE - 3) CHU
Nantes, Pediatric Radiology, Nantes, FRANCE - 4) CHU Angers, Pediatric Oncology, Angers, FRANCE
PURPOSE
Image Defined Risk Factors (IDRF) represent a list of preoperative protocol criteria to assess poten-
tial resectability of neuroblastoma, hence the need for preoperative chemotherapy. We investigated
the prevalence of renal vessels infiltration criteria, its evolution before/after chemotherapy, and its
impact on the risk of associated nephrectomy.
MATERIAL AND METHODS
Retrospective monocentric study of 81 consecutive abdominal neuroblastic tumours (1999–2016).
Double blinded review of all preoperative CT-scan studies (at diagnosis and after chemotherapy) by
pediatric surgeon and radiologist assessing the presence of the renal IDRFs (infiltration or encase-
ment of renal pedicle). Main outcome measures were difficulties of surgical resection, the need for
additional organ resection (based on surgical report), and the extent of surgical resection (based
on pathology report).
RESULTS
Among 28/81 children without any renal IDRF present at diagnosis, 27/28 underwent complete
macroscopic tumour resection, and none required nephrectomy in addition to tumour resection.
When infilitration of renal pedicle was present at diagnosis, it disappeared in 21/53 (40 %) after
chemotherapy, in whom none underwent nephrectomy. Among the 32 children who kept renal IDRF
after chemotherapy, 7/32 had macroscopic incomplete resection, and 12/32 required associated
nephrectomy. There was no difference between “infiltration” and “encasement” IDRFs to predict the
risk of associated nephrectomy (12/53, 23 % vs 11/35, 31 %, p=0,8).
CONCLUSIONS
Renal IDRFs are relevant to predict safe resectability of neuroblastoma. Children with IDRF which
disappear after chemotherapy achieve the same surgical outcome than those without IDRF.
08:35–08:40
S13-8 (VP)
PRONE RETROPERITONEOSCOPY FOR ADRENAL TUMORS
Maria Esmeralda KUAN
1
, Jerónimo GONZÁLAVEZ
1
, Natalia GALLEGO
1
, María
Soledad FERNÁNDEZ
2
and Pedro ALCARAZ
1
1) Hospital General Universitario de Alicante, Pediatric Surgery, Alicante, SPAIN - 2) Complejo Hospitalario Universitario
de Albacete, Pediatric Surgery, Albacete, SPAIN
PURPOSE
In adrenal tumors 5 cm or less, with no invasion and metastasis are feasible through MIS. Prono
retroperitoneoscopy is a feasible technique due to its direct access to the adrenal gland and its
vessels, avoiding the time and morbidity of mobilizing the colon in the transabdominal approach.