title: Managerial experiences on pediatric surgical tumors in Tribhuvan University Teaching Hospital.
abstract: BACKGROUND
  Pediatric tumors are least prioritized but serious problems. Multidisciplinary management improves survival. Incidences, types and follow up results on Nepalese pediatric tumors have not yet been studied. To highlight our center's experiences on pediatric tumors management and follow up is aimed.
  
  
  METHODS
  All pediatric surgical tumors admitted in pediatric surgery unit from 2065-2070 BS werer studied. Patients evaluated with or without chemo/radiotherapy pre or post surgery. Total of 22 cases from age four months to 13 years were studied.
  
  
  RESULTS
  Tumor detection shown highest in age group below 3 years, followed by 5-10 years. Mean age was 54 months. Most common problem (22.7%) was Sacrococcygeal teratoma (histologically matured). 13% Nephroblastoma, 9% ovarian tumor, 9% Neuroblastoma and various others each were 4.45%. Majority underwent surgical excision of tumors. Three cases pre surgery and 5 post-surgery, received chemotherapy. Rest had only excision of tumor mass. Follow up were from three weeks to five years period. During this period, two patients expired (one due to complication of second cycle of chemotherapy and second one died with severe aspiration after second laparotomy for intestinal obstruction one year after initial Nephroblastoma excision.) One patient lost for follow up after excision of stage V Nephroblastoma and first cycle of chemotherapy.
  
  
  CONCLUSIONS
  Management of pediatric tumors is complicated. Thus it needs better multidisciplinary centre of excellence for satisfactory results. Management is directed according to incidence, types, standard management protocol, which is not studied yet in Nepal. Research on pediatric tumors is virgin area. Large scale studies need to conduct in detail and a center of excellence is essential to provide better services.
authors.affiliation: Department of Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal.
authors.forename: Rameshwar Prasad
authors.initials: RP
authors.lastname: Pokharel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D009390:Nepal; D009447:Neuroblastoma / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000601:surgery*; D009396:Wilms Tumor / Q000601:surgery*