title: Nephron sparing surgery for unilateral non-syndromic wilms tumor.
abstract: The initial therapy for most children with Wilms tumor is radical nephrectomy. Several centers, have explored the role of Nephron-sparing procedures in children with unilateral non-syndromic Wilms tumors. The primary motivation for this approach is concern about late occurrence of renal dysfunction after unilateral nephrectomy. We report our experience with NSS for unilateral non-syndromic Wilms tumor. We reviewed the records of nine children who underwent nephron sparing surgery for unilateral, nonsyndromic Wilms tumors at our Hospital between Jan 2000 through Jan 2012. All patients received preoperative chemotherapy with two drugs (vincristine, and dactinomycin) following which patients underwent tumor resection. Subsequent renal function was assessed by estimating the glomerular filtration rate using creatinine clearance and other measures of long-term renal function assessment included blood pressure evaluation and the need for antihypertensive medications. During the study period nine children with a mean age 19.66 ± 14.37 months at diagnosis and presenting with unilateral non-syndromic Wilms tumor underwent nephron sparing surgery. In all the nine children, the renal plane of resection showed a tumor-free margin. Post-operative serum creatinine repeated at the end of 3 months revealed maintenance of good renal function in all children. Nephron sparing surgery is a safe and effective option in the management of early stage unilateral non-syndromic Wilms tumor. It is oncologically safe and does not lead to decreased local tumor control. The function of the kidney remnant remains rather well.
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India ; Department of Urology, KLE University's JN Medical College, Belgaum, 590010 India.
authors.forename: R B
authors.initials: RB
authors.lastname: Nerli
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India.
authors.forename: V C
authors.initials: VC
authors.lastname: Pujar
authors.affiliation: Department of Studies in Biotechnology & Microbiology, Karnatak University, Dharwad, India.
authors.forename: M B
authors.initials: MB
authors.lastname: Hiremath
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India.
authors.forename: S M
authors.initials: SM
authors.lastname: Jali
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India.
authors.forename: S S
authors.initials: SS
authors.lastname: Joshi
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India.
authors.forename: S C
authors.initials: SC
authors.lastname: Hiremath
authors.affiliation: KLES Kidney Foundation, KLES Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka India.
authors.forename: A K
authors.initials: AK
authors.lastname: Guntaka
keywords: Child; Nephrectomy; Nephron sparing surgery; Wilms tumor