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Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Introduction La tumeur de Wilms (TW) est la tumeur rénale la plus fréquente chez l’enfant, dont le traitement de référence reste la néphrectomie totale (NT). Son taux de guérison, proche de 90 %, permet d’envisager une désescalade thérapeutique. À travers une revue de la littérature, cette étude a pour objectif d’évaluer l’intérêt de la néphrectomie partielle (NP) dans la prise en charge des TW unilatérales (TWU) chez l’enfant. Méthodes Une recherche systématique des articles de la base de données Medline comportant dans leur titre les mots « unilateral Wilms tumor, unilateral nephroblastoma, partial nephrectomy, nephron sparing surgery, renal function » a été effectuée, permettant une analyse qualitative des données des articles retenus. Résultats Sur 377 articles, 14 concernant 4288 enfants ont été retenus après lecture complète. Une NT avait été réalisée chez 3994 patients (93,1 %) et une NP chez 294 patients (6,9 %), le stade I concernant respectivement 55,1 % et 79 % des cas. La survie globale et sans progression de la maladie avait été proche, quelle que soit la technique chirurgicale : respectivement 95,7 % et 92,8 % après NT, 96 % et 90,5 % après NP. Le taux de marges positives avait été supérieur en cas de NP (8,5 % contre 0,5 %) mais le nombre de ruptures tumorales peropératoires et de récurrences locales avait été proche, quelle que soit la technique. Le taux de maladie rénale chronique (débit de filtration glomérulaire < 60 mL/min/1,73 m 2 ) après 10 ans était plus élevé après NT (42 % contre 10 % en cas de NP). Conclusion La néphrectomie partielle pour TWU semble être une alternative thérapeutique envisageable sous certaines conditions. Les tumeurs de stade I seraient les meilleures candidates à cette chirurgie d’épargne néphronique. Summary Background Wilms tumors (WTs) are the most frequent renal tumors in children. Radical nephrectomy (RN) remains the gold-standard surgical treatment for this type of cancer. Excellent results in overall survival (> 90%) make it possible to consider nephronic preservation. The objective of this systematic review is to evaluate the relevance of nephron-sparing surgery (NSS) for the treatment of nonsyndromic unilateral Wilms tumor (UWT) in children. Methods Articles in English related to “unilateral Wilms tumor, unilateral nephroblastoma, partial nephrectomy, nephron-sparing surgery, renal function” identified in the Medline library were screened and data were extracted to perform a qualitative systematic review. Results We identified 377 articles, 14 of which were integrated into the analysis. Data on 4288 children were included, 3994 (93.1%) underwent RN, whereas 294 (6.8%) underwent NSS. Stage I anatomopathology resulted in 55.1% RN and 79% NSS. Overall survival and event-free survival were similar: respectively 95.7% and 92.8% after RN and 96 and 90.5% after NSS. Positive margin status was higher after NSS (8.5% vs 0.5%), but tumor rupture and local tumor recurrences were similar. The rate of mild to moderate renal function was higher after RN (42% vs 10% after NSS). Discussion NSS is regularly performed for WT in case of bilateral or syndromic tumors, but the literature considering UWT does not show consensus. The superiority of NSS for renal outcomes has now been fully evaluated, but the main problem of this surgery in case of UWT is to ensure oncologic outcomes as good as outcomes after RN. WTs are usually massive tumors for which partial nephrectomy is contraindicated, but studies showed that chemotherapy before surgery could reduce tumor volume and make NSS possible. This review shows that NSS results seem to be as good as RN results and that preoperative chemotherapy should be highlighted for its participation in the reduction of the positive margin status. Although radiotherapy is used with caution because of its side effects, some studies showed that it gave excellent results for oncologic salvage after local recurrence. Constant progress in medical imaging and detection systems has led to the emergence of a new type of assistance for surgeons such as image reconstruction and vessel or urinary tract system segmentation. Virtual simulation of the operation based on a real case should help evaluate the feasibility of complex procedures in the near future. Conclusion NSS for UWT seems to be a credible therapeutic alternative. New technologies such as 3D reconstruction should help surgeons define the best parameters to select ideal tumors for this surgery in the near future. For the moment, small tumors (< 4 cm), distant from the renal hilum (ideally on the upper pole) that respect at least 50% of the renal parenchyma (ideally superficial with exophytic development) seem to be the perfect indication for NSS. [ABSTRACT FROM AUTHOR]

Summary Eikenella corrodens (EC) is a human commensal microorganism of the mouth flora. This bacterium is rarely reported in bone and joint infections in children, but the consequences on the joint function can be devastating and irreversible. We report the case of septic arthritis of the hip following an oral wound in a 12-year-old boy. The progression of the condition was favorable with no complications or pain observed after antibiotic treatment. Clinical and radiological examinations showed a satisfactory outcome at 6 months with no sign of recurrence or complication (growth disorder). Children's osteomyelitis and arthritis caused by EC have been mostly reported after human bites or extremity pricks. This slow-growing organism is rarely diagnosed but should be considered as a potential pathogenetic agent and treated aggressively, especially since the antibiotic therapy is simple and achieves good results. Level of evidence Level IV. [ABSTRACT FROM AUTHOR]

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)