ABSTRACT
BACKGROUND: Bladder cancer occurs mainly in adults. In children, younger than 10 years in particular, it is very rare. OBJECTIVES: The aim of the study is to retrospectively evaluate the efficacy of transurethral resection of the bladder tumour (TUR-BT) of transitional cell carcinoma (TCC) of the bladder in children. MATERIAL AND METHODS: Transurethral resection of the bladder tumour was performed in 7 boys aged 4 to 17 years (median 12.1 years). In all cases laboratory tests, ultrasound, and cystoscopic tumour biopsy were carried out prior to the resection. Doxorubicin was additionally instilled intravesically as one dose in two patients. The Foley catheter was left in the bladder for 1 to 4 days (median 1.85 days). The follow-up period ranged from 10 months to 10 years (median 4 years). RESULTS: Papillary urothelial neoplasm of low malignant potential (PUNLMP) was diagnosed in 5 patients and urothelial papilloma in 2. Local recurrence was observed in one case two years after the resection. In all other cases complete remission was achieved. CONCLUSIONS: Transitional cell carcinoma of the bladder in children is usually benign and endoscopic treatment (TUR-BT) seems to be the treatment of choice. To determine a follow-up schedule a more substantial group of children with bladder cancer should be analysed.
Subject(s)
Carcinoma, Transitional Cell/surgery , Cystectomy/methods , Urinary Bladder Neoplasms/surgery , Administration, Intravesical , Adolescent , Age Factors , Antibiotics, Antineoplastic/administration & dosage , Carcinoma, Transitional Cell/pathology , Chemotherapy, Adjuvant , Child , Child, Preschool , Cystectomy/adverse effects , Doxorubicin/administration & dosage , Humans , Male , Neoplasm Recurrence, Local , Poland , Remission Induction , Retrospective Studies , Time Factors , Treatment Outcome , Urinary Bladder Neoplasms/pathologyABSTRACT
AIM: Objective analysis of clinical and epidemiological aspects of minor head injuries in children with an attempt to elaborate a practical algorythm for diagnostic management. MATERIAL AND METHODS: All children aged 3 to 18 years with minor head injury treated in the years 2005-2006 in the Department of Paediatric Surgery and Traumatology in Grudziadz, were included in a prospective study. In all, 884 children were enrolled into this analysis. Their medical data were reviewed with an emphasis on circumstances of injury, clinical signs and symptoms, diagnostic and therapeutic management its evaluation and final outcome. RESULTS: Loss of consciousness and/or postinjury amnesia were noted in 88 patients (9.3%). Skull x-ray carried out in 486 children revealed bone fracture in 4 cases. 473 (53.5%) children were hospitalised, while 411 (46.5%) were discharged after initial examination for home the care. Among 82 children who had computed tomography, intracranial pathology was found in 17. None of the patients from either group required surgical intervention and all were discharged in a good condition. CONCLUSIONS: From clinical point of view, it seems relevant to separate the group of patients with minimal head injury requiring no diagnostic study and hospitalization. Loss of consciousness and posttraumatic amnesia in children with minor injury should be treated as an indication for computed tomography and/or observation of the patient in hospital. The role of conventional x-ray in minor head injury is minimal. The presented practical diagnostic algorythm for children with minor head trauma, treated in emergency departments in Poland appears to be fully justified and important.
