Advances in Pediatric Surgery

[English]

A Case of Intrarenal Neuroblastoma: Airi Han, Seok Joo Han, Jung Tak Oh, Seung Hoon Choi, Eui Ho Hwang; J Korean Assoc Pediatr Surg 2000;6(2):156-159. Published online December 31, 2000; DOI: https://doi.org/10.13029/jkaps.2000.6.2.156

Abstract
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Neuroblastoma arises from the embryonic tissue of the adrenergic rest. It is commonly found in children and mostly in nonrenal tissue. We present a case of intrarenal neuroblastoma which was initially thought to be a Wilms' tumor. The patient was a 18 months-old girl treated with radical nephrectomy and adjuvant chemotherapy after operation. The neoplasm within the kidney in children cannot always indicate Wilms' tumor. Neuroblastoma of the adrenal gland or retroperitoneal tissue may often compress or invade the kidney directly or arise from the kidney. Clinical aspects that differentiate between neuroblastoma and Wilms' tumor are discussed with a review of the literatures.

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[English]

Clear Cell Sarcoma of the Kidney: A case report: Park, Jae Hyun , Jung, Jae Hee , Lee, Ah Won , Song, Young Tack; J Korean Assoc Pediatr Surg 2001;7(2):162-165.; DOI: https://doi.org/10.13029/jkaps.2001.7.2.162

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Clear Cell Sarcoma of the Kidney (CCSK) is a rare malignant childhood tumor with frequent metastasis to the bone. We report a case of right sided in a 5 month-old girl. A radical nephrectomy was performed. It was clinical stage III with renal capsular invasion and lymph node metastasis by the classification of NWTS-5. Histologic examination revealed the classic pattern of CCSK. Postoperative adjuvant chemotherapy with doxorubicin and radiotheraphy were applied.

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[English]

Kidney Transplantation in Children Weighing 15 kg or Less: Technical Challenges and Outcome in a Single Center: Lee, Chi Hoon , Oh, Chaeyoun , Lee, Sanghoon , Lee, Okjoo , Lee, Kyo Won , Park, Jae-Berm; Adv Pediatr Surg 2021;27(2):67-72.; DOI: https://doi.org/10.13029/aps.2021.27.2.67

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Purpose
Kidney transplantation (KT) in small children is known to be associated with increased risk of surgical complications that may potentially lead to graft loss. KT in children weighing 15 kg or less are considered to be most technically challenging. We present our transplant center's experience with KT in this cohort of children.
Methods
We retrospectively reviewed our transplant center's KT database from January 1994 to July 2019. Recipients’ and donors' data were collected for analysis.
Results
From January 1995 to July 2019, 69 cases of KT were performed in recipients ≤18 years. We identified 9 children (11.8%) who weighed ≤15 kg at the time of KT. There were 4 boys and 5 girls. Median age of recipients was 4.0 years (range 16 months–7 years). Median weight at KT was 14.0 kg (range, 11–15 kg). 3 cases were living-donor KT and 6 cases were deceased-donor KT. Median weight of the kidney allograft was 106 g (range, 65–235 g). The allograft was implanted intraperitoneally in 6 cases and extraperitoneally in 3 cases. Postoperative vascular complication occurred in 1 patient (arterial anastomosis stenosis). Graft loss occurred in 2 patients, due to renal artery stenosis and chronic allograft nephropathy. Graft survival was 88.9% and 88.9% at 1 and 5 years, respectively. Mean followup was 91.6 months. Graft survival of children who weighed ≤15 kg at the time of KT was not different compared to children who weighed more than 15 kg.
Conclusion
KT in small children weighing ≤15 kg is technically challenging. However, with comprehensive care by a pediatric transplant specialist, these challenges may be overcome and lead to good transplant outcomes.