用于治疗肾母细胞瘤 (WT) 的全肾切除术越来越多地通过腹腔镜检查进行，尽管目前遵循 UMBRELLA 指南的这种方法的适应症非常有限。本研究的目的是评估 WT 微创方法对 UMBRELLA 方案标准的遵守情况。这项回顾性多中心研究包括 2020 年之前因疑似 WT 接受腹腔镜全肾切除术的儿童。影像学进行了集中审查。56患者（50 名 WT 和 6 名肾源性休息）接受手术的中位年龄为 3.3 ± 2.6 岁。十三名 (23%) 患者在诊断时已发生转移。平均手术时间为 213 ± 84 分钟。共有 8 例 (14.3%) 中转和 5 例围手术期并发症。 7 例 (12.5%) 病例确诊为局部 III 期，其中 2 例因肿瘤破裂。只有一项 (1.8%) 手术遵循 SIOP-UMBRELLA 腹腔镜手术指征。 “正常薄壁组织环”的标准仅满足一次。十例（17.9%）病例似乎可以进行保守手术。化疗后肿瘤延伸超出椎骨同侧边缘且体积超过 200 mL 与转化风险增加相关（分别为 p = 0.0004 和 p = 0.001）。平均随访5.2±4.0年，虽然没有出现局部复发，但术后15个月发生1例因转移进展死亡。超出UMBRELLA建议的腹腔镜手术方法可行，局部复发风险较低。其适应症可能会更新和验证。© 2024。外科肿瘤学会。

Total nephrectomies for the treatment of Wilms' tumor (WT) are more and more performed by laparoscopy, although indications for this approach following the UMBRELLA guidelines are currently very restrictive. The purpose of this study was to assess the compliance to the criteria of the UMBRELLA protocol for minimally invasive approach of WT.This retrospective multicenter study included children operated on by laparoscopic total nephrectomy for suspected WT before 2020. Imaging was reviewed centrally.Fifty-six patients (50 WT and 6 nephrogenic rests) were operated on at a median age of 3.3 ± 2.6 years. Thirteen (23%) patients had metastasis at diagnosis. The mean operative time was 213 ± 84 min. There were eight (14.3%) conversions and five peroperative complications. A local stage III was confirmed in seven (12.5%) cases, including two for tumor rupture. Only one (1.8%) of the procedures followed the SIOP-UMBRELLA indications for laparoscopy. The criterion "ring of normal parenchyma" was met only once. Conservative surgery seemed possible in ten (17.9%) cases. The extension of the tumor beyond the ipsilateral edge of the vertebra after chemotherapy and a volume over 200 mL were associated with an increased risk of conversion (p = 0.0004 and p = 0.001 respectively). After a mean follow-up of 5.2 ± 4.0 years, although there was no local recurrence, one death occurred due to metastatic progression at 15 months postoperatively.The laparoscopic approach of WT beyond the UMBRELLA recommendations was feasible with low risk of local recurrence. Its indications may be updated and validated.© 2024. Society of Surgical Oncology.