The Significance of Retroperitoneal Extensive Dissection for Nephroblastoma

Nephrectomy for Nephroblastoma has been performed on 60 patients over a 6 years period since May,1986.On 38 patients in addition to nephrectomy,anextensive retroperitoneal dissection was performed,Group Ⅰ:the tumor in 24 patients was confined to the kidney and completely resected.Group Ⅱ:8 cases with local extension of the tumor were completely resected and Group Ⅲ:in 6 patients,the tumor was ruptured during or before surgery.Positive finding of local metastasis of tumor by microscopic examination of the excised specimen was proved in 11 patients of Group Ⅰ(45.8%),6 patients in Group Ⅱ(75%)and 6 in Group Ⅲ(100%).The local metastases were identified.The necessity and significance of retroperitoneal extensive dissection along with nephrectomy in the treatment of nephroblastoma are demonstrated in this study.There was no major complication or death in our series.The anatomy of retroperitoneal space and the technique of extensive dissection are also discussed.