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Home News and Update Year 2010 Wilms’ Tumour Removed From Four-Year-Old

Wilms’ Tumour Removed From Four-Year-Old

Times of India
04 September 2010
Pune, India

Four–year–old Danish Tamboli, son of a scrap dealer, is all smiles again after undergoing a critical surgery for removing Wilms’ tumour – a type of kidney cancer that affects children.

However, the unusual thing about Danish was that the tumour had spread to the inferior vena cava (IVC), the main vein of the lower trunk, and the right heart chamber. The surgery was conducted by doctors at the KEM Hospital, using a technique which has never been used before to treat such a tumour in children of Danish’s age.

Wilms’ Tumour Removed From Four-Year-Old
"Danish was diagnosed with the Wilms’ tumour, involving the left kidney, in July. The affected kidney along with the tumour were removed and then the extension of the tumour into the IVC and the heart was also removed using a technique called deep hypothermic circulatory arrest," said cardiac surgeon Sameer Bhate and paediatric surgeon Shashank Shrotriya, who operated upon the child on August 4.

The child made uneventful recovery and is now being managed by pediatric oncologist Vibha Bafna at the Bharati Vidyapeeth Medical College.

"Danish will need three cycles of chemotherapy to cure him completely. Considering the low recurrence rate of Wilms’ tumour, Danish is likely to have a near normal life," said Shrotriya.

Explaining the surgery, Bhate said, "In the technique of deep hypothermic circulatory arrest (DHTCA), all the blood of the patient is drained into the heart–lung machine (oxygenator) after cooling the body temperature of patient to 14 degrees centigrade. This allows stopping the circulation for 40 minutes without causing any damage to the brain and other important organs in the body. It allows access to all the major blood vessels and repair their defects without the risk of bleeding."

This technique is primarily used in complicated heart defects surgery and Aortic arch surgery. Wilms’ tumour is extremely uncommon to embolise (spread) into the heart. "The case of Danish is unique as never before such a procedure has been reported in this age group in India. This has not been reported so far in Indian medical literature," said Bhate. The team led by these two surgeons comprised of anesthetists Sameer Gothavadekar, Ruchira Patil, Geeta Akhade and perfusionist Bakul Lawate.

The child was fortunate to benefit by a donation made by the Bharathi Heart Trust Foundation, Sydney, a trust set up by Raj Gupta – a pharmacist and philanthropist based in Australia. Both Bhate and Shrotriya have not charged anything for the surgery.

In another surgery, a seven–day–old baby was also successfully operated for narrowing of the major blood vessel arising from the heart (coarcation of aorta).

"The baby required artificial lung support (ventilator) and was diagnosed with coarcation of aorta, leading to heart failure, by neonatologist Sandeep Kadam of KEM Hospital in July. The child had an emergency surgery where the narrowing was removed and the aorta was joined together with suture.

The baby has made good recovery and is doing well and will have a near normal life," said Bhate. The surgical team led by Bhate comprised of senior cardiac surgeon Sudhir Bhate, anesthetists Sameer Gothavadekar, Ruchira Patil and Prashant Waghmare.

"We want people to realise that a multi–disciplinary approach can be used to manage patients like Danish and a newly–born baby.," said Shrotriya.

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