Summary
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.
Zusammenfassung
In 10 Jahren wurden in Münster 62 Kinder an Nierentumoren operiert. Chirurgisches Behandlungsziel beim Wilmstumor ist die radikale Ro-Resektion unter möglichst realistischer Einschätzung der Resektabilität. Eine Überschätzung der chirurgischen Möglichkeiten kann die Tumorruptur provozieren (3 Fälle), eine Überschätzung der Tumorausdehnung verleitet zu einer neoadjuvanten Überchemotherapie, die bei 3 Säuglingen eine vital bedrohliche venous occlusive disease der Lebervenen (VOD) nach sich zog.
Besondere Problematik bieten beidseitige (6 Fälle) bzw. multifokale Wilmstumoren (2 Fälle) und deren Abgrenzung von einer Nephroblastomatose (= Persistenz embryonalen Nierengewebes, 2 Fälle), einer fakultativen Präcancerose, die vierteljährlich Ultraschallkontrollen erfordert und bei einem Kind zum kontralateral metachronen Zweittumor führte.
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© 1996 Springer-Verlag Berlin Heidelberg
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Schaarschmidt, K., Ritter, J., Willital, G.H., Olesczcuk-Raschke, K., Kindhäuser, V., Tratmann, U.S. (1996). Beurteilung der Resektabilität von Wilmstumoren im Kindesalter. In: Hartel, W. (eds) Wahrung des Bestandes, Wandel und Fortschritt der Chirurgie. Langenbecks Archiv für Chirurgie, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80295-9_288
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DOI: https://doi.org/10.1007/978-3-642-80295-9_288
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