Early surgical management outcomes of children with Wilms’ tumour at Moi Teaching and Referral Hospital in Eldoret Kenya

Abstract

Background: Paediatric cancers such as Wilms’ tumour are a major cause of morbidity and mortality while also interfering with the quality of life among affected children. This creates a need for early detection and intervention to improve management outcome.

Purpose: To evaluate the early surgical outcomes of children with Wilms’ Tumour at a resource constrained teaching hospital in Western Kenya.

Materials and Methods: A prospective study among children with Wilms’ tumour who underwent radical nephroureterectomy at Moi Teaching and Referral Hospital. They were reviewed prior to surgery while diagnostic and neoadjuvant chemotherapy sessions data were obtained through chart reviews. Clinical staging was determined using diagnostic radiology while sociodemographic data was collected using a questionnaire. Statistical associations between patient characteristics and surgical outcomes were determined.

Results: Of the 30 children studied; 19 (63.3%) were females with an overall mean age of 3.8 (SD± 1.5) years. All the children presented with abdominal mass with 66% of the masses being on the left side. Majority (53.3%) of them received 6 cycles of neoadjuvant chemotherapy. The early postoperative complications were intestinal obstruction (6.7%), surgical site infection (3.3%) and tumour rupture (3.3%). Averagely, the children stayed in the post-operative surgical ward for 6.5 (SD±1.6) days. There was a statistically significant association between duration of symptoms and duration of surgical ward stay (p=.044). No perioperative deaths were observed over the 12-day follow-up duration in the surgical ward.

Conclusions: This study reports favourable early surgical outcomes among children with Wilms’ tumour who underwent radical nephrouretectomy.