Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Prechemotherapy Transperitoneal Robotic‐Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four‐Years‐Old Patient

Marcello Della Corte
* ORCID logo ,
Elisa Cerchia
,
Marco Oderda
,
Paola Quarello
ORCID logo ,
Franca Fagioli
,
Paolo Gontero
,
Simona Gerocarni Nappo
Version 1 : Received: 18 September 2023 / Approved: 19 September 2023 / Online: 20 September 2023 (05:02:48 CEST)

A peer-reviewed article of this Preprint also exists.

Della Corte, M.; Cerchia, E.; Oderda, M.; Quarello, P.; Fagioli, F.; Gontero, P.; Gerocarni Nappo, S. Prechemotherapy Transperitoneal Robotic-Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four-Year-Old Patient. Pediatr. Rep. 2023, 15, 560-570. Della Corte, M.; Cerchia, E.; Oderda, M.; Quarello, P.; Fagioli, F.; Gontero, P.; Gerocarni Nappo, S. Prechemotherapy Transperitoneal Robotic-Assisted Partial Nephrectomy (RAPN) for a Wilms Tumor: Surgical and Oncological Outcomes in a Four-Year-Old Patient. Pediatr. Rep. 2023, 15, 560-570.

Abstract

Background: Wilms tumor (WT) is the main renal tumor in children. SIOP-UMBRELLA Guidelines admit Nephron sparing surgery (NSS) in syndromic patients, and in small (<300 ml) nonsyndromic unilateral WTs, without lymph node involvement, and with a substantial expected remnant renal function, after neoadjuvant chemotherapy. We report our prechemotherapy transperitoneal robot-assisted partial nephrectomy (RAPN) in a unilateral non-syndromic Wilms tumor. Methods: A 6-year-old-child showed an exophytic 3.6 cm diameter solid rounding mass involving the upper right renal pole at an incidental abdominal echotomography. CT-scan and abdominal MRI proved no local infiltration neither lymph node involvement was appreciated, suggesting an exophytic mass easily resectable through a NSS robotic approach, with a low risk of rupture and no subverted renal anatomy. The preoperative imaging was not suggestive for WT. A virtual 3D reconstruction of the tumor was performed. Results: the oncologic board approved a robot-assisted partial nephrectomy with the intraperitoneal approach. The histopathologic analysis displayed a WT. The patient underwent 10 vincristine-doses adjuvant chemotherapy. 28-months follow-up showed no tumor recurrence. Conclusions: Intraperitoneal RAPN can represent an opportunity for WT and needs to be assessed as a challenging possibility. This case suggests a potential role of prechemotherapy RAPN in the near future for highly selected patients.

Keywords

Wilms Tumor; nephron‐sparing surgery; robotic surgery; partial nephrectomy; 3D reconstruction; DaVinci; metaverse; 3D virtual models

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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