Surgical complications after nephrectomy for Wilms' tumor

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Nephrology

Background:

• Wilms tumor is a common pediatric kidney cancer.
• Primary nephrectomy is a standard treatment for Wilms tumor.
• Surgical complications can impact patient outcomes.

Purpose of the Study:

• To analyze the incidence and types of surgical complications in children undergoing primary nephrectomy for Wilms tumor.
• To identify factors associated with the development of surgical complications.
• To evaluate the impact of surgical complications on patient survival.

Main Methods:

• Retrospective chart review of 1,910 children from the Third National Wilms' Tumor Study.
• Exclusion of patients with inoperable tumors, bilateral disease, perioperative therapy, or treatment refusal.
• Analysis of complication rates, types, and associated risk factors.

Main Results:

• 19.8% of children (379/1,910) experienced surgical complications.
• Intestinal obstruction (6.9%) and extensive intraoperative hemorrhage were most common.
• Nine deaths (0.5%) were attributed to surgical complications.
• Survival rates were similar for patients with and without complications.
• Advanced stage, intravascular tumor extension, and resection of other organs were associated with complications.

Conclusions:

• Surgical complications are relatively common in pediatric nephrectomy for Wilms tumor.
• Risk factors include advanced tumor stage and extensive tumor involvement.
• Preoperative therapy may reduce morbidity in high-risk cases.
• Complete tumor removal should be balanced with minimizing surgical morbidity.