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肾母细胞瘤管理全国调查

National Survey on the Management of Wilms Tumor.

作者信息

Elgendy Ahmed, Shehata Sherif, Medhat Zaki Ahmed, Shehata Sameh

机构信息

Surgical Oncology Unit.

Pediatric Surgery Department, Tanta University, Tanta.

出版信息

J Pediatr Hematol Oncol. 2019 May;41(4):280-285. doi: 10.1097/MPH.0000000000001289.

Abstract

This study aims to investigate the management of Wilms tumor by the Egyptian pediatric surgical association (EPSA) consultants. After approval of the EPSA executive board, a questionnaire was distributed individually to all consultants attending the general assembly of EPSA 2017 annual congress. Of 88 consultants, responses were received from 61. Palpable abdominal mass was indicated by 72.13% of respondents as the commonest presenting symptom. Concerning the imaging requested, computed tomography was reported by 80.33%. Approximately 62.30% of respondents perform 1 to 3 cases annually. Regarding timing of surgery, upfront resection was the most frequently reported by 62.30%. A total of 77.05% perform lymph node sampling during surgeries. Nephron-sparing surgery was adopted by only 26.23%, whereas none of the respondents reported the use of minimally invasive surgery for management. Overall, 93.44% of surgeons ask for a visit every 3 months in the first year postoperatively. Upfront nephrectomy is the commonest procedure for Wilms tumor in the current practice of EPSA consultants, whereas there is consensus against minimally invasive surgery. Surgical guidelines for nephron-sparing surgery are still incomplete and need to be tabulated. This study urges for a nationwide retrospective analysis to establish a uniform protocol with international reference to be adopted in Egypt.

摘要

本研究旨在调查埃及小儿外科协会(EPSA)顾问对肾母细胞瘤的治疗情况。经EPSA执行委员会批准,向参加2017年EPSA年会大会的所有顾问单独发放了一份问卷。88名顾问中,收到了61份回复。72.13%的受访者指出可触及的腹部肿块是最常见的首发症状。关于所需的影像学检查,80.33%的受访者报告为计算机断层扫描。约62.30%的受访者每年进行1至3例手术。关于手术时机,62.30%的受访者最常报告为 upfront 切除。共有77.05%的人在手术期间进行淋巴结采样。仅26.23%的人采用保留肾单位手术,而没有受访者报告使用微创手术进行治疗。总体而言,93.44%的外科医生要求在术后第一年每3个月进行一次随访。在EPSA顾问目前的实践中,upfront 肾切除术是肾母细胞瘤最常见的手术方式,而对于微创手术存在共识反对。保留肾单位手术的外科指南仍然不完整,需要进行整理。本研究敦促进行全国范围的回顾性分析,以建立一个统一的方案并参考国际标准在埃及采用。

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