Publication:

A study of surgical profile of patients with Wilms’ tumor

Background Much of the early treatment of Wilms, tumour was unsuccessful because of the high mortality from the nephrectomy in the nineteenth century. Radiotherapy was first attempted in 1915, but by 1936, fewer than 20% of the Patients with wilms’ tumour survived. The objective was to study the staging and treatment modalities of Wilm’s tumor.

Methods Present study was Hospital based prospective study among 44 patients. Institutional Ethics Committee permission was obtained prior to the study. All the patients were explained the complete protocol of the study and their informed written consent was taken. Study was carried out at Department of General Surgery of a Tertiary care hospital for a period of one year.

Results The youngest patient of Wilms’ tumor was found to be of 8 month old, while patient was of 8 years. The age group of 0-2 years consists of highest number of cases. Maximum number of cases of Wilms’ tumor was presented with lump in abdomen i.e, 12 cases (92.30%). Maximum number of patients was in stage III (42.67%). In one patient staging was not possible because he was absconded before treatment. Nephrectomy with postoperative chemotherapy was given in maximum number of cases (30.76%). Biopsy was done where tumor mass was adherent to adjoining visceras.

Conclusions Male to female ratio in case of Wilms’ tumors is almost equal (1:1.6). Bilateral Wilms’ tumors are rare, found in 7.7% of cases. Lump in Abdomen was the common feature in Wilms’ tumor. Maximum cases of Wilms’ tumor were in stage III. Maximum cases of Wilms’ tumor were treated with nephrectomy along with postoperative chemotherapy i.e. Vincristine and Actinomysin D in combination. Wilms’ tumor 30.76% and renal pelvic tumors 42.85% for 2 year.