ABSTRACT
Wilms tumor and hepatoblastoma are the most common intra-abdominal solid organ childhood tumors. CT examination is one of the routinely performed procedures in hospitals for children with these tumors inspite of high radiation exposure associated with CT scans. Sixty patients (Wilms tumor = 45, hepatoblastoma = 16) were evaluated retrospectively. Higher proportion (44.4%) of metastatic disease was identified at presentation in the Wilms tumor subset as compared to hepatoblastoma (6.3%) [p=0.006]. Metastatic disease was noted in 6 patients having Wilms tumor on follow-up while it was also low in hepatoblastoma which was noted in only 2 patients (p > 0.05). No significant difference was identified in pelvic extension of disease at presentation in both studied population (p > 0.05). Pelvic metastasis was noted in 1 patient only with Wilms tumor on follow-up while no pelvic metastasis was seen in the hepatoblastoma patients (p-value > 0.05).
Subject(s)
Hepatoblastoma/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Pelvis/diagnostic imaging , Tomography, X-Ray Computed/methods , Wilms Tumor/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Hepatoblastoma/epidemiology , Hepatoblastoma/pathology , Humans , Infant , Kidney Neoplasms/epidemiology , Kidney Neoplasms/pathology , Liver Neoplasms/epidemiology , Liver Neoplasms/pathology , Male , Mass Screening , Neoplasm Metastasis , Pelvic Neoplasms/epidemiology , Pelvic Neoplasms/pathology , Radiation Dosage , Retrospective Studies , Wilms Tumor/epidemiology , Wilms Tumor/pathologyABSTRACT
Children with cancer especially acute leukaemia undergo multiple painful procedures like bone marrow biopsy (BM) and lumber puncture (LP) for intrathecal chemotherapy during their first year of treatment. The purpose of this study is to report safety and efficacy of Procedural Sedation and Analgesia (PSA) by paediatric intensivist for oncology procedures in controlled setting in paediatric oncology unit. During 20 months, 124 children received PSA for 499 procedures. 324 LP alone, 175 BM alone and 40 combined LP and BM were done. The most common diagnosis was acute leukaemia and lymphoma. All procedures were in compliance with American Society of Anaesthesiology guidelines. A small-dose of ketamine and intermittent doses of propofol was administered intravenously until needed. No procedure was aborted due to sedation. All patients tolerated the procedure well without any major adverse events. There were few transient respiratory adverse events which resolved with minor interventions. PSA for children undergoing oncology procedures, can safely and effectively be provided by paediatric intensivist in controlled setting by using a standardized sedation protocol outside the operating room.
