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Surgery for Solid Tumour Removal in Bhubaneswar

Surgery for Solid Tumours in Children

Surgery for Solid Tumour Removal in Bhubaneswar

Solid tumours in children require surgery as a crucial part of their treatment. 

Before Surgery:

  • Diagnosis and Evaluation: Imaging scans and biopsies confirm solid tumour presence and determine the extent.

  • Preoperative preparation: The medical team ensures the child's optimal condition through tests and consultations.

  • Patient education: Children and their families are educated about surgery, risks, benefits, and recovery, with emotional support provided.

  • Nutritional support: Dietitian assesses and optimises the child's nutritional status pre-surgery.

During Surgery:

  • Anaesthesia: The child will be administered anaesthesia for unconsciousness and pain management.

  • Surgical Procedure: Paediatric oncology surgeons remove tumours while preserving healthy tissue.

  • Intraoperative Monitoring: Vital signs, blood loss, and tissue oxygenation are monitored closely.

  • Surgical Techniques: Various techniques are employed based on tumour location and size, including open surgery or minimally invasive procedures.

After Surgery:

  • Recovery and Observation: The child is monitored post-anaesthesia for vital signs and pain management.

  • Wound Care: Proper wound care to prevent infection and promote healing is provided with instructions.

  • Pain Management: Medications and non-pharmacological interventions utilised for pain relief.

  • Physical Therapy and Rehabilitation: Physical therapy is initiated to regain strength, mobility, and function.

  • Follow-up Care: Regular appointments to monitor recovery, assess complications, and adjust treatment plans as needed.

FAQ's

Solid tumours in children are diagnosed through a series of diagnostic procedures, including:

  • Imaging scans such as MRI, CT scans, or ultrasound provide detailed images of the affected area, aiding in tumour localization and assessment of its size and extent.

  • Biopsies, which involve the removal of a small sample of tissue from the tumour, are crucial for confirming the presence of a solid tumour and determining its type through pathological examination.

Preoperative preparation for children with solid tumours involves several specialised considerations:

  • Comprehensive medical evaluations, including blood tests and a review of medical history, are conducted to ensure the child is in optimal condition for surgery.

  • Anesthesiologists and surgical teams collaborate to develop personalised anaesthesia plans considering the child's age, weight, and medical history to minimise risks during surgery.

  • Child life specialists provide age-appropriate education and emotional support to alleviate anxiety and fear associated with surgery, helping children and their families understand the procedure, potential risks, benefits, and what to expect during the recovery process.

  • Nutritional assessments and interventions by dietitians are implemented to optimise the child's nutritional status before surgery, ensuring adequate nourishment and enhancing recovery outcomes.

Surgical techniques for solid tumours in children vary based on factors such as tumour type, size, location, and extent of spread. Common surgical approaches include:

  • Traditional open surgery involves making an incision to directly access and remove the tumour, allowing surgeons to visualise and manipulate tissues more directly.

 

  • Minimally invasive procedures, such as Laparoscopy or Robotic-Assisted Surgery, utilise smaller incisions and specialised instruments equipped with cameras and robotic arms controlled by surgeons. These techniques offer advantages such as reduced postoperative pain, shorter hospital stays, and faster recovery times.

Pain management for children undergoing surgery for solid tumours is a critical aspect of their care.

 

During surgery, anesthesiologists administer anaesthesia to ensure the child is unconscious and pain-free throughout the procedure.

 

Postoperatively, a multimodal approach to pain management is often employed, combining medications such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anaesthetics with non-pharmacological interventions like physical therapy, relaxation techniques, and distraction therapies to alleviate pain and discomfort.

 

Pain management plans are tailored to the child's individual needs, with close monitoring and adjustments made as and when necessary.

Solid tumours in children can encompass various types, including neuroblastoma, Wilms' tumour (nephroblastoma), hepatoblastoma, osteosarcoma, rhabdomyosarcoma, and brain tumours such as medulloblastoma and gliomas. Each type presents unique challenges and considerations for surgical management.

The primary goals of surgery for solid tumours in children include complete or maximal tumour removal while preserving surrounding healthy tissue, achieving negative surgical margins to minimise the risk of tumour recurrence, and minimising functional impairment or long-term side effects. Additionally, in some cases, surgery may serve a diagnostic purpose through tumour biopsy or debulking to facilitate subsequent treatments.

Surgical planning varies depending on factors such as tumour location, size, proximity to vital structures, and the potential for metastasis. For example, in cases of neuroblastoma, surgical resection may be preceded by chemotherapy to shrink the tumour and facilitate a less extensive surgical procedure. In contrast, tumours located in critical areas such as the brain or spinal cord may require intricate surgical techniques to minimise damage to surrounding healthy tissue.

While surgery is generally considered safe, there are inherent risks and potential complications, including bleeding, infection, damage to adjacent organs or structures, nerve injury, and anaesthesia-related risks. The likelihood and severity of complications depend on factors such as the tumour's location and size, the complexity of the surgical procedure, the child's overall health, and the expertise of the surgical team.

Advancements in surgical techniques, such as minimally invasive approaches (e.g., Laparoscopy, Robotic-Assisted Surgery), intraoperative imaging modalities (e.g., intraoperative MRI, ultrasound), and surgical navigation systems, have revolutionised the management of solid tumours in children. These advancements enable more precise tumour localization, improved visualisation of critical structures, reduced surgical trauma, shorter recovery times, and enhanced cosmetic outcomes.

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