Surgery for wilms’ tumor, does preoperative chemotherapy ease its surgieal proeedure?

الملخص EN

Background: The optimal timing ©f surgery for Wilms’ tumor has been debated for many years.

It appears dubious whether surgical ease or per operative implications consistently improved after preoperative chemotherapy.

Objective: To compare the use of immediate nephrectomy versus delayed nephrectomy آ 0 partial nephrectomy following nco adjuvant chemotherapy for treatment of non metastatic Wilms’ tumor, in terms of surgical morbidity and per operative complications .

Materials and Methods: Thi؛> is a cross section study ,the sample collected from January 2009 to November ا 0ث 2 .Thirty four parents were selected after informed consent.

Patient؛؛ aged between 10 months and 5 years who were newly diagnosed with Wilms’ tumors, including (17) patients with unilateral wilms tumors received immediate nephrectomy without preoperative chemotherapy according to the National Wilms’ Tumor Study Group protocol (NWTS) and (16) patients with unilateral Wilms’ tumors and one patient with bilateral wilms tumor received delayed nephrectomy or partial nephrectomy following preoperative chemotherapy according to the International Society o fP e ،^ tr؛c Oncology( SIOP) WILMS TUMOR 2001/ UK Final Version /January 2002 protocol.

Results: there is significant change in the maximal tumor size (more than 50% reduction in the maximal tumor diameter) was observed in 52.9% of patients receiving pre operative chemotherapy.

There is reduction in the complication rate in those patient receiving pre operative chemotherapy.

These observed specifically for decreasing residual tumor and tumor spillage episodes.

Bilateral partial nephrectomy after neo adjuvant chemotherapy was done for one patient (5.6%) ١٧١^١٦ bilateral wilms tumor.

We found significant decrease 11؛ the complication rate mainly for those patients with high risk score receiving pre operative chemotherapy rather than those with low risk score -