Akademik Veri Yönetim Sistemi
Cocuk Cerrahisi Dergisi, cilt.30, sa.1, ss.31-49, 2016 (Scopus)
© Cocuk Cerrahisi Dergisi. All rights reserved.Aim: The aim of this study is to give the outlines of recent developments in the treatment of special conditions such as: bilateral Wilms' tumor,vascular extension of Wilms' tumor,horshoe kidney and Wilms' tumor and also to present the clinical experience of a teaching institution in this field. Material and Method: The recent publications of NWTS (COG) and SIOP related with above mentioned subjects and our clinical documents were retrospectively reviewed. Results: -Recently nephrone sparing procedures became popular in bilateral Wilms' tumor. These conservative procedures did not change the survival rates,but decreased the rates of kidney insufficiency percentages in long-term period. -Vascular extension of tumor thrombi did not change the survival rates. However there was a significant operative morbidity as far as atrial thrombus are concerned. Therefore preoperative neoadjuvant chemotherapy should be used especially in thrombis which are extending up to right atrium. -For the Wilms' tumors arising from horseshoe kidneys, preoperative chemotherapy seems very effective to increase the percentage of remnant of healthy kidney tissue. Besides preoperative imaging techniques such as CT angiography seems very important since thsee tumors may have various additional vascular branches. In conclusion, these special conditions need close collaboration among pediatric oncologists, surgeons, pathologists and pediatric anesthesiologist. We think this special conditions has to be treated in special units with pediatric oncologic council facilities and experienced staff.