A Scoping Review on Fluorescence-Guided Surgery in Paediatric Renal Tumours: Current Perspectives and Future Plans

TL;DR

This review explores the use of fluorescent dyes in pediatric kidney tumor surgery to improve precision and reduce tissue damage.

Contribution

The paper provides a scoping review of current and future fluorescence-guided surgery applications in pediatric renal tumors.

Findings

Only five relevant studies were identified, including one ex vivo study and one ongoing trial.

There is currently limited evidence supporting the use of near-infrared fluorescence in this context.

The review highlights the need for further research to guide clinical adoption.

Abstract

Fluorescence-guided surgery using special dyes to identify specific tissues during surgery is growing in popularity. It can be used to identify lymph nodes that need removing to look for the spread of some cancers or tumours. Additionally, work is underway to develop dyes that show tumour borders, allowing surgeons to identify where cancers stop so they can remove all possible disease, as well as for the removal of less normal tissue. This review summarises recent work and future plans with respect to such dyes in paediatric renal cancer.

Background/Objectives: Paediatric renal tumours, particularly Wilms tumours, have good survival outcomes following multimodal therapy; however, long-term morbidity related to nephrectomy and adjuvant treatment remains a major concern. As treatment paradigms increasingly prioritize nephron preservation and minimization of late effects, there is growing interest in technologies that can enhance intraoperative precision. Methods: A scoping review following the PRISMA guidelines was performed. We analysed articles on fluorescence for childhood renal tumours on 1 November 2025. Case reports, opinion articles, and narrative reviews were excluded. An Ovid Medline search with search terms “Kidney neoplasm” AND “Fluorescent Dyes”, along with a Cochrane trials registry search for “kidney” AND “neoplasm” AND “Fluorescent Dye”, was performed, along with a hand search of citations. Results: The Ovid Medline search yielded 21 results, and the Cochrane trials search gave 4 results. Following review, five papers were included, of which one was an ex vivo study and one was a randomised, controlled trial that is currently recruiting. Conclusions: There is a lack of evidence around the use of near-infrared fluorescence in paediatric renal tumour surgery. This review summarizes the key current findings and future perspectives.

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