Nephron-sparing approach to bilateral Wilms' tumor: in situ or ex vivo surgery and radiation therapy.

Abstract:

:Bilateral Wilms' tumor patients, who experience local recurrence after maximal multimodality therapy, present a difficult surgical problem. The role of surgery in the management of these patients has changed from ablation to preservation of renal tissue, with bilateral nephrectomy as a last resort. Two children who had recurrent tumors in the remaining kidney underwent nephron-sparing surgery and focal intraoperative radiation therapy. In one case, this nephron-sparing surgery and intraoperative radiation therapy were performed in situ, in the other kidney was removed and reimplanted (ex vivo bench surgery and irradiation). These techniques may allow complete obliteration of gross and microscopic disease, while maximizing residual renal function.

journal_name

J Pediatr Surg

authors

Longaker MT,Harrison MR,Adzick NS,Crombleholme TM,Langer JC,Duncan BW,Halberg FE,Salvatierra O Jr

doi

10.1016/0022-3468(90)90382-j

subject

Has Abstract

pub_date

1990-04-01 00:00:00

pages

411-4

issue

4

eissn

0022-3468

issn

1531-5037

pii

S0022346890001567

journal_volume

25

pub_type

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