Early surgical outcomes of children with wilms’ Tumor at a teaching Hospital in Western Kenya

Abstract

Purpose: To evaluate the early surgical outcomes of children with Wilms’ Tumour at a teaching hospital in Western Kenya. Patients and Methods: A cross-sectional study was conducted among children diagnosed with Wilms’ tumour at Moi Teaching and Referral Hospital over a one-year period. The participants’ data on sociodemographic and clinical characteristics were collected using an interviewer administered questionnaire. Data on preoperative chemotherapy cycles, staging and predominant histological component, tumour rupture, early postoperative complications, duration of stay in surgical unit and mortality were obtained through chart reviews. Statistical association between patient characteristics and surgical outcomes were done. Results: Thirty children with Wilms’ tumour were recruited into the study, with a mean age of 3.8 (SD± 1.5) years and a female to male ratio of 1.7:1. They all presented with an abdominal mass. The median duration of symptoms was 8 weeks (IQR 4, 12) prior to admission. Over half (53.3%) of the participants received 6 cycles of neoadjuvant chemotherapy while the rest received more. Two thirds of the tumours were on the left side while 53% of all tumours were classified as intermediate risk tumours. The early postoperative complications were intestinal obstruction (6.7%), surgical site infection (3.3%) and tumour rupture (3.3%). Post-operatively, patients stayed an average of 6.5 (SD±1.6) days in the surgical ward. There was a statistically significant association between duration of symptoms and surgical ward stay period (p=.044). There was no correlation between sociodemographic characteristics, clinical staging, and post operative complications. None of the children died peri-operatively. Conclusions: The Early surgical outcomes were favourable despite late presentation that increased the duration of stay in the surgical ward.