Bilateral Nephron-Sparing Surgery (NSS) is the gold standard as surgical treatment for children suffering from bilateral renal tumors. Whereas this approach is easy to achieve in peripheral tumors, it represents a relevant challenge in lesions that are centrally located. Involvement of the collecting system, localization deep within the renal parenchyma, and proximity to the central renal vessels are often difficult to deal with. A relevant number of patients thus receive unilateral total nephrectomy or undergo incomplete resections. However, surgery can often be performed successfully through experienced surgeons in centers of excellence, even though conditions for resection appear dismal on preoperative imaging. In this article, the authors describe technical aspects of Nephron-Sparing Surgery in complex conditions of bilateral pediatric renal tumors.
Seminars in pediatric surgery. 2019 Nov 15 [Epub]
Steven W Warmann, Jörg Fuchs
Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: ., Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.