[Assessment of the resectability of Wilms' tumors in childhood]

Over the last ten years 62 children were operated for renal tumours. The therapeutic aim in Wilms' tumours is complete macroscopic resection of the primary tumour, assessing resectability as accurately as possible. Overestimating surgical possibilities may lead to intraoperative rupture of the tumour (three cases), while overestimating local tumour extent may result in too much preoperative chemotherapy, which resulted in the life-threatening complication of venous occlusive disease of the hepatic veins (VOD) in three infants. The assessment of resectability may become particularly problematic in bilateral (six cases) or multifocal Wilms' tumours (two cases), and in nephroblastomatosis (two cases), i.e. the persistence of embronal renal tissue, a facultatively precancerous lesion, which requires quarterly sonographic controls and which induced a second metachronous contralateral Wilms' tumour in one child.