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Sacrococcygeal teratoma: Improved haemostasis after aprotinin
118
INTERNATIONAL
ABSTRACTS
options are discussed in the article). Patients with prunr belly syndrome require careful lifelong follow-up including regular assessment of kidney and bladder function.-Patricia Daridsorr
greater in boys (5 of 12) than in girls (I of 9). The pelvic organs were preserved in 75% of the girls: the bladdrr was retained in 44%
NEOPLASMS
is concluded that a conservative surgical approach combined with chemotherapy is justified. Although late relapses occur, they can usually be salvaged by a combination of chemotherapy, radio therapy, and surgery-George W Holcornb, Jr
Urogenital Rhabdomyosarcoma in Children: Is a Conservative Surgical Approach Justified? H.A. Heij, A. I/OS,J. de Kraker, et al. J Urol 150:165-168, (July), 1993. Between 1970 and 1990,23 patients were treated for embryonal rhabdomyosarcoma of the bladder (8), prostate (7) uterus (4) or vagina (4). One girl underwent exenteration without chemotherapy, and 22 patients received chemotherapy as initial treatment. There was one treatment-related death. A total of 21 patients completed the first phase: four were treated with chemotherapy alone and 17 subsequently underwent an operation. Three boys underwent total cystoprostatectomy, and local resection was performed in 14 patients. One boy was lost to follow-up. The mean follow-up was 11.2 ? 6.3 years for 15 survivors. Complete remission was achieved in 19 patients, and 11 (53%) had relapse at an interval of 3 to 102 months. Of 13 patients with bladder and prostate tumors, eight had relapse and seven survived. Of eight patients with uterine and vaginal tumors, three had relapse and all survived. Six patients died of recurrent disease (overall mortality rate, 32%). The interval from initial diagnosis until death was always less than 5 years. The mortality rate was
of the boys. Because relapse occurred in patients in whom tumor was found in the resection specimen after chemotherapy,
no it
Sacrococcygeal Teratoma: Improved Haemostasis After Aprotinin. J.A. Morecroft, A.D. Lander, M.R.J. Buy, et al. Pediatr Surg Int 8:366-367, (May), 1993. The authors report on the first infant undergoing noncardiac surgery (resection of sacrococcygeal teratoma) in whom aprotinin was used. After induction of anesthesia, 40,000 Kalhkrein inhibitory units (KLU) of aprotinin were intravenously infused over 5 minutes. A large sacrococcygeal teratoma (Altman type 3) was resected, with a total blood loss of 30 mL as compared with 118 mL (range, 60 to 250 mL) in 5 similar cases operated on by the same surgeon previously. Hemorrhage is the most important cause of mortality in sacrococcygeal teratoma. As this is the first case report. further studies will be required to evaluate the efficacy of aprotinin in pediatric surgical operations requiring extensive dissection.--R. Swan0
INTERNATIONAL
ABSTRACTS
options are discussed in the article). Patients with prunr belly syndrome require careful lifelong follow-up including regular assessment of kidney and bladder function.-Patricia Daridsorr
greater in boys (5 of 12) than in girls (I of 9). The pelvic organs were preserved in 75% of the girls: the bladdrr was retained in 44%
NEOPLASMS
is concluded that a conservative surgical approach combined with chemotherapy is justified. Although late relapses occur, they can usually be salvaged by a combination of chemotherapy, radio therapy, and surgery-George W Holcornb, Jr
Urogenital Rhabdomyosarcoma in Children: Is a Conservative Surgical Approach Justified? H.A. Heij, A. I/OS,J. de Kraker, et al. J Urol 150:165-168, (July), 1993. Between 1970 and 1990,23 patients were treated for embryonal rhabdomyosarcoma of the bladder (8), prostate (7) uterus (4) or vagina (4). One girl underwent exenteration without chemotherapy, and 22 patients received chemotherapy as initial treatment. There was one treatment-related death. A total of 21 patients completed the first phase: four were treated with chemotherapy alone and 17 subsequently underwent an operation. Three boys underwent total cystoprostatectomy, and local resection was performed in 14 patients. One boy was lost to follow-up. The mean follow-up was 11.2 ? 6.3 years for 15 survivors. Complete remission was achieved in 19 patients, and 11 (53%) had relapse at an interval of 3 to 102 months. Of 13 patients with bladder and prostate tumors, eight had relapse and seven survived. Of eight patients with uterine and vaginal tumors, three had relapse and all survived. Six patients died of recurrent disease (overall mortality rate, 32%). The interval from initial diagnosis until death was always less than 5 years. The mortality rate was
of the boys. Because relapse occurred in patients in whom tumor was found in the resection specimen after chemotherapy,
no it
Sacrococcygeal Teratoma: Improved Haemostasis After Aprotinin. J.A. Morecroft, A.D. Lander, M.R.J. Buy, et al. Pediatr Surg Int 8:366-367, (May), 1993. The authors report on the first infant undergoing noncardiac surgery (resection of sacrococcygeal teratoma) in whom aprotinin was used. After induction of anesthesia, 40,000 Kalhkrein inhibitory units (KLU) of aprotinin were intravenously infused over 5 minutes. A large sacrococcygeal teratoma (Altman type 3) was resected, with a total blood loss of 30 mL as compared with 118 mL (range, 60 to 250 mL) in 5 similar cases operated on by the same surgeon previously. Hemorrhage is the most important cause of mortality in sacrococcygeal teratoma. As this is the first case report. further studies will be required to evaluate the efficacy of aprotinin in pediatric surgical operations requiring extensive dissection.--R. Swan0