Bilateral nephrectomy for Wilms tumor

Bilateral nephrectomy was performed in 4 patients with bilateral Wilms tumor. The current philosophy regarding the need to preserve maximum renal parenchyma is discussed. New guidelines suggested by the National Wilms Tumor Study group discourage unilateral nephrectomy and partial nephrectomy at initial exploration for bilateral Wilms tumor. Alternatively, it is recommended that continued treatment with chemotherapy and/or radiation therapy followed by second and third-look operations to maximize preservation of renal parenchyma be done with bilateral nephrectomy as a last resort option.