الفهرس | Only 14 pages are availabe for public view |
Abstract Wilms’ tumor (WT) is the commonest solid kidney tumor in children. Interestingly, the prognosis of WT has improved substantially, with 5-y OS rates > ninety percent. The involvement of LNs in WT is accompanied by a bad prognosis. Therefore, cautious LNs assessment should be performed aiming to detect higher-risk cases who will need more intensive treatment and prevent a local recurrence of this disease. The goal of this study was to assess the outcome of hilar LNs sampling in comparison to comprehensive LNs dissection as regards the pathological results of the LNs post nephrectomy in cases suffering WT with correlation to comorbidities for the two approaches postoperatively. A prospective study included 20 pediatric patients diagnosed as WT who were operated by nephrectomy with LNs sampling and comprehensive LN dissection in the same surgical setting. In our study, the comparison between LN dissection and hilar LN sampling showed a statistically significant elevated number of excised LNs in dissection vs. the number of excised LNs in sampling. However, there was no statistically significant result as the yield of excised LNs. Our results indicate that hilar LNs sampling might be preferred over LNs dissection, despite they providing the same operating outcomes, the dissection has several technical difficulties and a higher risk of complication in comparison with sampling. Most of the patients had no complications, whereas 3 patients had a diaphragmatic injury as a result of the attached tumor, and only one patient had chylous acities. |