Retroperitoneal neuroblastoma often wraps around the kidney and other important retroperitoneal vessels, resulting in surgical failure to remove the tumor or the need to remove it along with the kidney. In our early treatment, although the tumor was completely removed in one stage, the kidney was often sacrificed because the anatomy of the renal vessels was very thin near the renal hilum, making surgery difficult. As we gained experience with the vascular skeletonization approach, we felt that complete removal of the tumor while preserving the kidney was feasible. In the actual surgery later on, we did achieve it. Preserving the kidney has a huge impact on the child’s body and on the parents’ psychology. A few pictures of recent surgical cases are selected to share with you. 1. Case 11, CT at the time of consultation (2011.10), the tumor wrapped the main retroperitoneal vessels, the left kidney artery and vein were all wrapped, and the left kidney function was poor (the left kidney was poorly visualized during enhancement) 2. After 3 courses of chemotherapy (2011.12), the tumor shrank significantly and the left kidney function improved, but the left kidney artery and vein were still wrapped. However, the artery and vein of the left kidney were still wrapped. We thought that if we continued chemotherapy, the situation would not change and it would increase the chance of tumor resistance, so we decided to operate. 3. The tumor was completely removed and the left kidney was preserved. The vessels shown are, from top to bottom: superior mesenteric artery; left and right renal arteries (marked with red bands); left renal vein (marked with blue bands); inferior mesenteric artery (not marked); left ureter (marked with yellow bands) Case 2 1. The tumor was present at the time of consultation (2011.8), and both renal vessels were involved. 2.After 3 courses of chemotherapy (2011.10), the tumor shrank and the renal vessels were still wrapped, so continued chemotherapy would not change and increase the chance of tumor resistance. 3. Surgery was performed to completely remove the tumor and preserve both kidneys. The picture shows the complete resection of the tumor around the artery and vein of the left kidney and the preservation of the left kidney. The blood vessels from top to bottom are: celiac trunk artery, superior mesenteric artery, left renal vein, left renal artery, and right renal artery.