Last Updated on December 1, 2025 by Bilal Hasdemir

Wilms tumor is a rare kidney cancer that mainly affects children. About 650 new cases are diagnosed in the United States each year.

Step-by-step explanation of the primary method of Wilms tumor surgery used to remove the mass.

Thanks to advances in diagnosis and treatment, children’s chances of survival have greatly improved. We will look at how to remove a Wilms tumor. This includes diagnosis, surgical methods, and care after surgery.

Our guide gives a detailed look at nephrectomy and other treatments. It aims to help you understand the surgery and what to expect during recovery.

Key Takeaways

• Understanding Wilms tumor and its impact on children
• Overview of diagnosis and treatment options
• Surgical approaches for Wilms tumor removal
• Post-operative care and recovery expectations
• The role of nephrectomy in treating Wilms tumor

Understanding Wilms Tumor

Wilms tumor is the most common kidney cancer in kids. It’s important for doctors and families to know about it. We’ll look at what it is, how common it is, who’s at risk, and the signs that lead to diagnosis.

What is a Wilms Tumor?

Wilms tumor, or nephroblastoma, starts in the kidneys. It grows into a big tumor before it’s found. It’s usually found in kids aged 2 to 5. The tumor can be in one or both kidneys and might be linked to genes or other health issues.

Prevalence and Risk Factors

Wilms tumor is rare, making up 6% of childhood cancers. Some genetic conditions like WAGR syndrome, Denys-Drash syndrome, and Beckwith-Wiedemann syndrome raise the risk. Family history also matters, with some cases linked to family members.

Signs and Symptoms

The symptoms of Wilms tumor vary but include:

• A palpable mass or swelling in the abdomen
• Abdominal pain
• Fever
• Blood in the urine (hematuria)
• High blood pressure

Spotting these symptoms early is key to treating it well. Recognizing them can help kids get the care they need sooner.

Diagnosis and Staging Process

Understanding how to diagnose and stage Wilms tumor is key to creating a good treatment plan. This process involves several tests to find out if cancer is present and how far it has spread.

Initial Diagnostic Tests

The first step in diagnosing Wilms tumor is a physical check-up and looking at the patient’s medical history. We also do blood and urine tests to see if there are any signs of cancer.

Some tests we use at first include:

• Complete Blood Count (CBC)
• Urine Analysis
• Blood Chemistry Tests

Imaging Studies

Imaging tests are very important in finding and understanding Wilms tumor. They help us see the tumor, its size, and where it is.

Some imaging tests we use are:

• Ultrasound
• Computed Tomography (CT) scans
• Magnetic Resonance Imaging (MRI)

Tumor Staging System

The tumor staging system helps us figure out how big the cancer is and where it is. We use a system based on how far the tumor has spread.

Stage	Description
I	The tumor is only in the kidney and is removed completely.
II	The tumor is bigger than the kidney but is removed.
III	The tumor can’t be removed completely or has spread to lymph nodes.
IV	The tumor has spread to distant places like the lungs, liver, or brain.
V	The tumor is in both kidneys.

Importance of Accurate Staging

Getting the tumor stage right is very important. It helps us choose the best treatment and know what to expect. It also tells us who needs more intense treatment and who can have less.

Knowing the tumor stage helps us make a treatment plan that fits the patient’s needs.

The Medical Team Involved in Wilms Tumor Surgery

Treating Wilms tumor needs a team of experts. We have a team that works together to care for our patients.

Pediatric Oncologists

Pediatric oncologists are key in treating Wilms tumor. They plan and carry out the treatment, like chemotherapy. They know a lot about treating cancer in kids.

“The pediatric oncologist is the main doctor for kids with Wilms tumor. They make sure all treatment parts work together.”

Pediatric Surgeons

Pediatric surgeons remove the Wilms tumor. They know how to operate on kids and handle Wilms tumor surgery. They are very important for removing the tumor well.

Specialist	Role in Wilms Tumor Treatment
Pediatric Oncologist	Creates and carries out non-surgical treatment plans, like chemotherapy.
Pediatric Surgeon	Does the surgery to remove the Wilms tumor.
Anesthesiologist	Gives anesthesia during surgery to keep the child comfortable and safe.
Support Staff	Provides nursing care, emotional support, and handles the practical parts of care.

Anesthesiologists

Anesthesiologists are important in surgery. They make sure the child is comfortable and pain-free during surgery. They are experts in anesthesia for kids with Wilms tumor.

Support Staff

The support staff, like nurses, are very important. They give emotional support, handle the practical parts of care, and help with the treatment plan.

This team works together to give kids with Wilms tumor the best care. This helps them have a good chance of successful treatment.

Pre-Surgical Preparation

Getting ready for Wilms tumor surgery is key. It includes many medical checks and steps.

Medical Evaluations

Before surgery, doctors do a full check-up. They look at your health and find any risks.

These checks include:

• Blood tests to find anemia, infection, or other issues
• Imaging like CT scans or MRI to see the tumor’s size and where it is
• Heart checks to see how well it’s working

Preparing Your Child for Surgery

Getting a child ready for surgery is both physical and emotional.

It’s important to:

• Explain the surgery in simple terms your child can understand
• Talk about any fears or worries your child has
• Make sure your child knows why they must follow the pre-surgery instructions

Anesthesia Considerations

Anesthesia is very important for Wilms tumor surgery. It makes sure the patient is comfortable and safe.

The anesthesiologist will:

• Look at the patient’s medical history for any risks with anesthesia
• Talk about anesthesia options with the patient and family
• Make a plan for anesthesia that fits the patient’s needs

Pre-operative Chemotherapy

Pre-operative chemotherapy might be used to make the tumor smaller. This makes it easier to remove.

Whether to use chemotherapy before surgery depends on several things, like:

Factor	Description
Tumor size and location	Bigger tumors or those in hard-to-reach places might need chemotherapy first
Patient’s overall health	Some health issues might make chemotherapy a good choice
Tumor stage	The tumor’s stage can also decide if chemotherapy is needed before surgery

Wilms Tumor Surgery: Primary Surgical Approaches

It’s important to know the surgical options for Wilms tumor. The choice of surgery depends on the tumor’s size, location, and if it’s in one or both kidneys.

Radical Nephrectomy

Radical nephrectomy removes the whole kidney and the tumor. It’s often chosen for large tumors or high cancer spread risk. This method removes the tumor and surrounding tissue, lowering cancer return risk.

Partial Nephrectomy

Partial nephrectomy tries to keep as much kidney as possible. It’s used for smaller tumors in one kidney area. The aim is to keep kidney function while removing cancer.

Bilateral Tumor Considerations

When both kidneys have tumors, surgery gets more complex. The goal is to keep as much kidney function as possible. Planning for both tumors needs careful thought about their size and location.

• Assessing the extent of tumor involvement in both kidneys
• Determining the best approach to preserve kidney function
• Planning for post-surgical kidney support

Surgical Planning

Planning surgery for Wilms tumor is key. A team of healthcare experts looks at the tumor and the patient’s health. They decide the best surgery.

Open Surgery Technique for Wilms Tumor

Open surgery for Wilms tumor uses a laparotomy, a method improved over years. It lets surgeons directly reach the tumor and nearby tissues. This makes removing the tumor more thorough.

Laparotomy Procedure

A laparotomy is a cut into the belly. It’s key for removing Wilms tumor because it lets the surgeons get to the kidney and tumor easily. The team plans the cut carefully for the best access.

Abdominal Incision Types

There are different cuts made during a laparotomy. The choice depends on the tumor’s size and where it is. Some common cuts include:

• Transverse incision: Made across the belly, it’s chosen for its looks and lower risk of problems.
• Vertical incision: Goes from top to bottom, giving wide access to the belly.

Tumor and Kidney Removal Process

The main goal of open surgery for Wilms tumor is to take out the tumor and the kidney. The team carefully cuts around the tumor to avoid any leaks. Then, they remove the kidney and tumor together.

Lymph Node Sampling

Lymph node sampling is a big part of Wilms tumor surgery. It means taking out and checking lymph nodes near the tumor. This helps figure out how far the cancer has spread and plan treatment after surgery.

Understanding open surgery for Wilms tumor helps patients and families. They see the detailed work that goes into this life-saving surgery. Our team works hard to give the best care and outcomes for Wilms tumor patients.

Minimally Invasive Surgical Options

Minimally invasive surgery is changing how we treat Wilms tumor. It makes recovery less painful and faster. This is a big step forward in treating kids with cancer.

Laparoscopic Nephrectomy

Laparoscopic nephrectomy is a new way to remove a kidney. It uses small cuts and a camera to see inside. This method means less pain, shorter hospital stays, and quicker healing than old surgeries.

Robotic-Assisted Surgery

Robotic-assisted surgery is a big leap in surgery. It uses robots to help the surgeon, making the surgery more precise. It’s great for tricky cases, leading to better results and fewer problems.

Benefits and Limitations

These new surgeries have many good points. They cause less pain, leave less scars, and help you get better faster. But, they’re not for everyone. They might not work for big or complicated tumors. Also, not all places have the right doctors or tools.

Benefits	Limitations
Less postoperative pain	Not suitable for all patients
Shorter hospital stays	Limited availability of skilled surgeons
Quicker recovery times	Complex cases may require open surgery

Patient Selection Criteria

Choosing the right patient for these surgeries is key. We look at the tumor’s size and where it is, the patient’s health, and the disease stage. We pick the best surgery for each patient to get the best results.

In short, new surgeries like laparoscopic and robotic-assisted are big wins for Wilms tumor patients. They have their limits, but picking the right patients and improving technology make them safer and more effective.

Kidney-Sparing Surgery Techniques

Kidney-sparing surgery is a key treatment for Wilms tumor. It helps keep the kidney working well. This method is great for some patients, giving them a better choice than old surgeries.

Partial Nephrectomy Procedure

The partial nephrectomy removes the tumor but keeps most of the kidney. It needs careful planning and skill to work right.

Key Steps in Partial Nephrectomy:

• Preoperative imaging to assess tumor size and location
• Intraoperative ultrasound to guide tumor resection
• Careful dissection to preserve surrounding kidney tissue
• Reconstruction of the kidney to maintain its function

A top oncologist says, “Partial nephrectomy is a complex procedure. It needs a skilled team for success.”

“The goal of partial nephrectomy is not only to remove the tumor but to preserve kidney function, improving the patient’s quality of life.” – Pediatric Oncologist

Candidates for Kidney-Sparing Surgery

Not every Wilms tumor patient can have kidney-sparing surgery. The choice depends on the tumor’s size and location, the patient’s health, and the disease stage.

Candidate Criteria	Description
Tumor Size and Location	Tumors that are small and peripherally located are more suitable for kidney-sparing surgery.
Patient’s Overall Health	Patients with good overall health and minimal comorbidities are ideal candidates.
Disease Stage	Early-stage disease is more likely to be treated with kidney-sparing surgery.

Preservation of Kidney Function

Kidney-sparing surgery aims to keep the kidney working. By removing only the tumor, patients can keep their kidney function. This reduces the risk of future problems.

The importance of preserving kidney function cannot be overstated, as it directly impacts the patient’s quality of life and long-term health outcomes.

Technical Challenges

Kidney-sparing surgery is hard because it needs precise tumor removal and kidney reconstruction. Surgeons must be very skilled and experienced.

Understanding the techniques and challenges of kidney-sparing surgery helps us see how complex treating Wilms tumor is. This method is a valuable option for some patients, balancing tumor removal with kidney function preservation.

Intraoperative Considerations and Challenges

Intraoperative considerations are key in treating Wilms tumor. The team’s skill in handling challenges during surgery greatly affects the outcome.

Tumor Rupture Prevention

It’s vital to prevent tumor rupture during surgery. This avoids cancer cells spreading, which can make treatment harder and lower the chance of recovery. Careful handling of the tumor and keeping it intact are essential.

Surgeons use many methods to lower the risk of rupture. These include gentle dissection and early vessel ligation. The right tools and precise technique are vital for success.

Vascular Control Techniques

Effective vascular control is key in Wilms tumor surgery. It prevents heavy bleeding and keeps the surgical area clear. Early identification and ligation of major vessels are main strategies.

Vascular clamps and careful dissection around major vessels help control blood flow. Preoperative planning with imaging studies also helps in understanding the vascular anatomy, making surgery easier.

Managing Complex Cases

Some Wilms tumor cases are more complex, like tumor thrombus in major vessels or nearby structure involvement. A multidisciplinary approach involving pediatric surgeons, oncologists, and radiologists is often needed.

Consulting with specialists and using advanced imaging during surgery helps manage these complex cases. Flexibility and preparedness are essential for the surgical team.

Intraoperative Imaging

Intraoperative imaging, like ultrasound, is very helpful. It lets surgeons check if all tumor is removed and if there’s any left. Real-time feedback from imaging helps surgeons adjust their approach.

Using intraoperative imaging in surgery improves its precision. This leads to better results for Wilms tumor patients.

Potential Complications of Wilms Tumor Surgery

It’s important to know about the possible problems after Wilms tumor surgery. This surgery, like any, has risks of short-term and long-term issues.

Short-Term Surgical Complications

Right after surgery, patients might face infections, bleeding, or bad reactions to anesthesia. These problems are usually handled with good medical care and watching the patient closely.

• Infection: Doctors watch for signs of infection and use antibiotics when needed.
• Bleeding: Surgeons work hard to prevent bleeding during and after the surgery.
• Adverse reactions to anesthesia: Anesthesiologists keep a close eye on how patients react to the anesthesia.

Long-Term Complications

Long-term problems can happen, like kidney issues, tumor coming back, and new cancers. It’s key to have ongoing care to manage these risks.

1. Kidney function: Patients who had a kidney removed are checked regularly to avoid kidney damage.
2. Tumor recurrence: Regular check-ups and scans help catch any tumor return early.
3. Secondary malignancies: Keeping a close eye on patients is important to spot new cancers early.

Risk Factors for Complications

Some things can make surgery risks higher. Knowing these helps in planning better care for patients.

“Identifying risk factors for surgical complications is a critical step in optimizing patient outcomes.”

• Age and overall health of the patient
• Stage and size of the tumor
• Presence of any pre-existing medical conditions

Management Strategies

Handling complications well needs a team effort. This includes surgery, medicine, and support care.

Management strategies include:

• Preoperative planning to minimize risks
• Intraoperative techniques to reduce complications
• Postoperative care and monitoring
• Long-term follow-up to address any late effects

By knowing and tackling the possible problems of Wilms tumor surgery, doctors can give the best care to their patients.

Recovery and Life After Nephrectomy

Recovering from nephrectomy is more than just getting better physically. It’s also about adjusting to life with one kidney. Patients start their recovery journey with several important steps.

Physical Recovery Timeline

The time it takes to recover from nephrectomy varies. It depends on your health and the surgery’s complexity. Usually, patients spend a few days in the hospital to start their recovery.

Managing pain after surgery is key. Doctors use medicine and other methods to help with pain.

After leaving the hospital, patients should avoid hard work and heavy lifting for weeks. They can slowly get back to normal activities with their doctor’s advice.

Living with One Kidney

Living with one kidney means making some changes in your life. Your one kidney will work harder, so keeping it healthy is important. This includes drinking plenty of water, controlling blood pressure, and avoiding harmful substances.

Regular check-ups with your doctor are also important. They help keep an eye on your kidney’s health and overall well-being.

Long-Term Monitoring

Long-term care is essential for those who have had nephrectomy. Regular visits and tests help catch any problems early. This might include blood tests, imaging, and other tests as advised by your healthcare team.

Quality of Life Considerations

Quality of life after nephrectomy can be very good with the right care. Most people with one kidney can live active, normal lives. But, it’s important to be aware of long-term effects and keep a healthy lifestyle.

Understanding recovery and life after nephrectomy helps patients heal and stay healthy in the long run.

Post-Surgical Treatment and Follow-Up

The journey doesn’t end with surgery. Post-surgical treatment and follow-up are key for Wilms tumor patients. After removing the tumor, more treatments might be needed to stop it from coming back.

Adjuvant Chemotherapy

Adjuvant chemotherapy is often needed after surgery. It kills any cancer cells left behind. The type of chemotherapy depends on the tumor’s stage and type.

Chemotherapy agents like vincristine, dactinomycin, and doxorubicin are used. The treatment plan is made based on the patient’s risk and how they respond.

Radiation Therapy

In some cases, radiation therapy is used. It’s for patients with bigger tumors or certain types of cancer. It kills any cancer cells left in the abdomen or other areas.

Doctors decide on radiation therapy based on the tumor’s stage, the patient’s health, and how well surgery and chemotherapy worked.

“Radiation therapy is an important component of treatment for some Wilms tumor patients, helping to reduce the risk of recurrence.”

NCCN Guidelines

Surveillance Protocols

After treatment, patients are closely watched for any signs of cancer coming back. This includes imaging studies, physical exams, and lab tests.

Surveillance Component	Frequency	Duration
Physical Examination	Every 3-6 months	2-5 years
Imaging Studies (e.g., Ultrasound, CT)	Every 3-12 months	2-5 years
Laboratory Tests	As needed	Varies

Survival Rates and Prognosis

Thanks to better treatments, Wilms tumor survival rates have improved a lot. Early-stage disease patients have a high chance of survival.

Survival rates depend on the tumor’s stage, type, and how well the patient responds to treatment. In developed countries, the five-year survival rate for Wilms tumor is about 90%.

It’s important for patients and their families to understand post-surgical care. Working with their healthcare team helps them get through this critical phase and achieve the best results.

Conclusion

We’ve looked into the details of Wilms tumor surgery, a key part of treating childhood cancer. New surgical methods and care after surgery have greatly helped kids with this disease.

Learning about Wilms tumor treatment helps families understand the journey to recovery. The aim of surgery is to remove the tumor and keep the kidney working well. This ensures kids can live a good life.

We’re working hard to make Wilms tumor surgery even better. Our goal is to give top-notch care and support to patients from around the world. We’re focused on improving results and caring for kids with cancer.

FAQ

References

• Children’s Oncology Group. (2024). Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®)–Health Professional Version. National Cancer Institute. https://www.cancer.gov/types/kidney/hp/wilms-treatment-pdq
• Ehrlich, P. F., Ferrer, F. A., Ritchey, M. L., et al. (2022). Evidence-based surgical guidelines for treating children with Wilms tumour. Pediatric Blood & Cancer, 69(12), e30135. https://pubmed.ncbi.nlm.nih.gov/35929184/
• Theilen, T. M., Keenan, H. M., & Chintagumpala, M. (2022). Multidisciplinary treatment strategies for Wilms tumor. Frontiers in Pediatrics, 10, 852185. https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.852185/full