ESPU Congress 2018 - Abstract Book

110 29 th CONGRESS OF THE ESPU 08:24–08:29 S13-5 (VP) ROBOT-ASSISTED LAPAROSCOPIC NEPHROURETERECTOMY FOR WILMS' TUMOR : PRELIMINARY RESULTS Thomas BLANC  1 , Luca PIO  1 , Yves HELOURY  1 , Daniel ORBACH  2 , Véronique MINARD-COLIN  3 , Pauline CLERMIDI  1 and Sabine SARNACKI  1 1) Hôpital Necker - Enfants Malades, Department of Pediatric Surgery and Urology, Paris, FRANCE - 2) Institut Curie, Centre oncologie SIREDO (soins, innovation, recherche autour des tumeurs de l'enfant, l'adolescent e, Paris, FRANCE - 3) Gustave-Roussy, Département de cancérologie de l'enfant et l'adolescent, Villejuif, FRANCE PURPOSE The role of minimally invasive surgery for the treatment of Wilm’s tumors has been limited to pioneer groups. The purpose of this prospective study is to present the preliminary results of robot-assisted laparo- scopic (RAL) nephrectomy for Wilms’ tumor in the first year of a robotic program. MATERIAL AND METHODS Children with unilateral non-metastatic Wilms’ tumor were preoperatively treated according to the SIOP 2001 protocole, and afterwards were submitted to RAL nephrectomy and lymph node sam- pling. A four-trocar transperitoneal approach was used. The tumor was extracted inside a plastic bag and without morcellation through a Pfannenstiel incision. RESULTS 4 children underwent right RAL nephrectomy at a mean age of 4.6 years (3.7–5.2). The first patient was converted due to renal vein injury. The third patient had a misdiagnosed renal vein tumor thrombus found during the procedure. The nephrectomy was performed with the RAL technique. The thrombus could not be treated robotically, with conversion to open procedure. In all patients the tumor was completely removed, as well as lymph node samples and no ruptures occurred. The staging was: 2 stage I; 1 stage 2, 1 stage III (lymph nodes involvement). Three patients had a standard histology and 1 a diffuse anaplasia. The postoperative course was free of complications and all the patients were discharged from day 2 to day 7. No recurrences or long-term complications have been detected in 1–10 months of follow-up. CONCLUSIONS RAL nephrectomy for Wilms’ tumor is a feasible and safe procedure in a selected group of children after chemotherapy. It reproduces all the steps of the open surgical approach required to treat the tumor in order to maintain an excellent oncological result, with the advantages of a short hospital stay and cosmetically more acceptable incisions.