[Surgical management of bilateral Wilms' tumor: our experience with 18 cases].
OBJECTIVE
To show our experience in the surgical management of bilateral Wilms' tumor.


METHODS
We have reviewed the medical records of 18 patients diagnosed of bilateral Wilms' tumor between 1971 and 2007, evaluating age, sex, clinical situation, imaging studies, histology, treatment, complications and follow-up.


RESULTS
65% of patients with synchronous Wilms' tumor was stage I-II, 30% stage III and 5% stage IV. 100% of patients with metachronous Wilms' tumor was stage I-II. All the tumors had favourable histology. Surgical complications were: 4 bowel pseudobstructions, 2 ureteropielic fistulae and 1 urinary cyst. 15 patients are alive (83%) with a mean follow-up of 12 years. 3 of these patients had a renal trasplant with a good evolution. One patient died of a progressive renal failure and two patients died of the evolution of the oncological disease.


CONCLUSIONS
Preoperative chemotherapy allows a conservative surgical resection with a high overall survival (80-90%). Individualized surgical treatment offers a conservative surgical resection with a lower incidence of long-term renal failure.
Fernández-Pineda
I
I
Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Virgen del Rocío, Sevilla.
Cabello Laureano
R
R
Fernández-Hurtado
M A
MA
Granero Cendón
R
R
Tuduri Limousín
I
I
Morcillo Azcárate
J
J
Aspiazu Salinas
D
D
García Vallés
C
C
De Agustín Asensio
J C
JC
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D012189:Retrospective Studies; D009396:Wilms Tumor / Q000601:surgery*