일측성 Wilms 종양에서 대측신에 대한 외과적 관찰의 의의
Contralateral Surgical Exploration in Unilateral Wilms Tumor
정재일, 최호철, 최성협,
소속 상세정보
정재일 ( )
연세대학교
최호철 ( )
연세대학교
최성협 ( )
연세대학교
KMID : 0358319960370050531
Abstract
Contralateral exploration has become standard treatment of the unilateral wilms' tumor. The current preoperative imaging modalities including CT and ultrasongraphy are far superior teo the IVP at detecting contralateral disease in unilateral
Wilms'
tumor. The question must then be psoed whether contralateral exploration is still indicated in patient with negative preoperative imaging studies. We reviewed 18 patients of Wilms' tumor seen at our hospital from 1980 to 1995. All 18 patients had
unilateral disease in the preoperative CT and/or ultrasonography. Contralateral exploration was done in the early 3 patients (1980-1985). The results of imaging studies were confirmed on surgical exploration. The remaining 15 patients were not
explored
because the contralateral tumor was not found in the preoperative CT and ultrasonography. During the periodic follow-up with CT, 5 patients with high stage (III,IV0 and/or unfavorable histollogy were early expired. Two patients were not evaluable
owing
to short follow-up duration. The remnant 8 patients were free of disease clinically and radiologically during follow-up (mean duratin 51.5 months) .The current, acurate preoperative imaging modalities and effective chemotherapy suggest that
contralateral surgical exploration may no loner be mandatory in patients with unilateral Wilms' tumor despite of short follow-up duration and small number of patients.
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