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Wilms' tumour and hypertension: incidence and outcome
1Department of Paediatric Urology, Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital, UK.
Objective:
To determine the incidence and outcome of hypertension associated with Wilms' tumour and to reduce peri-operative morbidity by appropriate treatment.
Patients And Methods:
The medical and nursing case-notes of 17 consecutive patients with Wilms' tumour treated over a 5.5 year period (1989-1994) were analysed retrospectively.
Results:
Ten of 17 patients had hypertension, with a mean blood pressure of 150/103 mmHg (130-220 mmHg systolic and 85-145 mmHg diastolic). There was no significant difference between the hyper- and normotensive patients in their mode of presentation. Blood pressure was stabilized preoperatively in all the hypertensive patients. Perioperative monitoring in these patients was performed using arterial and central venous pressure lines. No patient had any peri-operative hyper- or hypotensive episodes caused by handling the tumour or after nephrectomy. Thirteen patients had a favourable histological diagnosis and all the hypertensive patients were in this group. The blood pressure of all patients returned to normal within 1 month of surgery.
Conclusion:
Both the recognition of hypertension and appropriate peri-operative treatment is mandatory for the safe surgical management of this condition.