WILMS-TUMOR AND HYPERTENSION - INCIDENCE AND OUTCOME

Objective To determine the incidence and outcome of hypertension assoc iated with Wilms' tumour and to reduce peri-operative morbidity by app ropriate treatment. Patients and methods The medical and nursing casen otes of 17 consecutive patients with Wilms' tumour treated over a 5.5 year period (1989-1994) were analysed retrospectively. Results Ten of 17 patients had hypertension, with a mean blood pressure of 150/103 mm Hg (130-220 mmHg systolic and 85-145 mmHg diastolic). There was no sig nificant difference between the hyper- and normotensive patients in th eir mode of presentation. Blood pressure was stabilized pre-operativel y in all the hypertensive patients. Peri-operative monitoring in these patients was performed using arterial and central venous pressure lin es, No patient had any peri-operative hyper- or hypotensive episodes c aused by handling the tumour or after nephrectomy. Thirteen patients h ad a favourable histological diagnosis and all the hypertensive patien ts were in this group. The blood pressure of all patients returned to normal within 1 month of surgery. Conclusion Both the recognition of h ypertension and appropriate peri-operative treatment is mandatory for the safe surgical management of this condition.