Wilms’ tumor is one of the most frequent tumors in childhood. The incidence of Wilms’ tumor in a horseshoe kidney is estimated at 0.4 to 0.9%. It is highly treatable but a fast growing tumor. Management of cancer patients has become a dilemma for surgeons, due to the impact of the COVID-19 pandemic on the health care sector globally. Reported here is a rare case of a 2 year old boy, diagnosed with Wilms’ tumor in a horseshoe kidney. This report aimed to highlight the multimodality treatment of Wilms' tumor and the modifications to cancer diagnostic and treatment protocols to adapt to the current health care crisis brought about by the pandemic.

OBJECTIVE

This seven-year, two-center retrospective cross-sectional study aimed to describe the demographic, clinical characteristics and surgical indications of patients managed with open or laparoscopic cholecystectomy in the pediatric age group, and determine these variables’ associations with patient outcomes.

METHODS

Records of all patients less than 19 years old who underwent laparoscopic or open cholecystectomy at Jose R. Reyes Memorial Medical Center (JRRMMC) and National Children’s Hospital (NCH) from January 2015 to December 2021 were reviewed. The gathered data were organized, described and analyzed using univariate and multivariate statistics.

RESULTS

A total of 32 patients underwent open or laparoscopic cholecystectomy at the two institutions. Majority were female (78.1%). The diagnoses included chronic calculous cholecystitis (62.5%), acute calculous cholecystitis (21.9%), choledocholithiasis (12.5%). One (3.1%) patient had empyema of the gallbladder. The 15 – 18 year age group made up 78.1%, with the rest (21.9%) from the 10 – 14 year age group. By BMI percentile, 62.5% were normal, 15.6% were overweight, and 12.5% were obese. Most patients across all conditions (96.9%) had no known hemolytic disorder. Underweight patients (9.4% of the cohort) had statistically higher lengths of stay [F(3,28) = 3.444, p = .030]. No significant associations were found between the categorical outcomes (discharged well, morbidity, mortality) and patient variables (age group, sex, BMI percentile, presence of co-morbidities, symptoms, indication for surgery, operation done).

CONCLUSION

In pediatric patients undergoing laparoscopic or open cholecystectomy, BMI percentile is inversely related to the length of hospital stay.

Human ; Cholecystectomy ; Gallbladder Diseases ; Demography