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De Win G, De Kort L, Learner H, Noah A, Dautricourt S, Nijman R, Stein R. Long-term risks of childhood surgery. J Pediatr Urol 2024; 20:165-172. [PMID: 37487882 DOI: 10.1016/j.jpurol.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Several patients, who underwent major reconstruction under the care of an experienced pediatric urologist are now, as adults, several years later, appearing with long term problems and complications. This consensus process was undertaken to give an overview of long term consequences (and their management) of urological childhood surgery. MATERIAL AND METHODS Several known urologists with experience in life-long follow up and revisional surgery of patients with congenital conditions were asked to review literature and comment based on their experience about several complications of childhood surgery. RESULTS Renal impairment, metabolic consequences, bladder stones, Vit B 12 deficiency and recurrent infections are often encountered. Also recurrent ureteric strictures and difficulties with catheterizable channel (both obstruction and incontinence) can be challenging to manage. Specific attention is needed regarding female sexuality and pregnancy. Both the development of malignancies in reconstructed bladders as secondary malignancies need to be taken into account during follow up. CONCLUSION Follow up of patients with rare congenital conditions is highly specialized and revisional surgery can be challenging. Therefore, follow up needs to be organized in specialized centers.
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Affiliation(s)
- Gunter De Win
- University Hospital Antwerp, Department of Urology, Edegem, Belgium; ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Adolescent & Congenital Lifelong Urology, University College London Hospitals, London, UK.
| | | | - Hazel Learner
- Adolescent Gynaecology, University College London Hospitals, London, UK
| | - Anthony Noah
- Adolescent & Congenital Lifelong Urology, University College London Hospitals, London, UK
| | | | - Rien Nijman
- Department of Pediatric Urology, University Medical Center Groningen, the Netherlands
| | - Raimund Stein
- Paediatric and Reconstructive Urology, University Hospital Mannheim, Germany
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Janecka A, Stefanowicz J, Owczarzak A, Tomaszewski M, Batko T, Irga-Jaworska N. Assessment of Metabolic Syndrome and Kidney and Heart Function in Childhood Cancer Survivors. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1073. [PMID: 37371304 DOI: 10.3390/children10061073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND The survivors of childhood cancer suffer from a number of long-term side effects. These include atherosclerosis and cardiovascular diseases (CVDs) that develop earlier in adulthood than in the rest of the population. The aim of this study was to identify prognostic factors of developing atherosclerosis before the development of symptomatic CVD. METHODS A total of 141 children that were 7-18 years old were examined; there were 116 survivors of childhood malignancies (hematopoietic and lymphoproliferative malignancies-52; neuroblastoma-22; Wilms tumor-24; other solid tumors-18) and 25 healthy controls. Anthropometric measurements, blood pressure measurements, ultrasonography of the abdomen, echocardiography, and laboratory tests were performed. RESULTS There were no significant differences in gender distribution, time from the end of the treatment, weight, BMI, prevalence of central obesity, blood pressure and resistive index of the renal arteries, lipid profile, or glucose and fibrinogen levels. Patients with solid tumors had a significantly lower height and worse renal function. Patients with hematological malignancies significantly presented the lowest shortening fraction of the left ventricle. The salusin β levels were significantly higher in the control group than among the patients. CONCLUSIONS The type and severity of side effects are closely related to the type of neoplasm and the treatment that has been undergone. Careful observation and regular follow-up are necessary.
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Affiliation(s)
- Aleksandra Janecka
- Department of Paediatrics, Haematology and Oncology, Faculty of Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdańsk, Poland
- Department of Paediatrics, Haematology and Oncology, University Clinical Centre, Debinki 7, 80-952 Gdansk, Poland
| | - Joanna Stefanowicz
- Department of Paediatrics, Haematology and Oncology, Faculty of Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdańsk, Poland
- Department of Paediatrics, Haematology and Oncology, University Clinical Centre, Debinki 7, 80-952 Gdansk, Poland
- Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Anna Owczarzak
- Department of Clinical Nutrition, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland
| | - Marek Tomaszewski
- Department of Paediatrics, Haematology and Oncology, University Clinical Centre, Debinki 7, 80-952 Gdansk, Poland
| | - Tomasz Batko
- Department of Paediatrics, Haematology and Oncology, University Clinical Centre, Debinki 7, 80-952 Gdansk, Poland
| | - Ninela Irga-Jaworska
- Department of Paediatrics, Haematology and Oncology, Faculty of Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdańsk, Poland
- Department of Paediatrics, Haematology and Oncology, University Clinical Centre, Debinki 7, 80-952 Gdansk, Poland
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Kooijmans ECM, van der Pal HJH, Veening MA, Bökenkamp A. Letter to the Editor. Kidney Int 2023; 103:227-228. [PMID: 36603973 DOI: 10.1016/j.kint.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Esmee C M Kooijmans
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | | | - Margreet A Veening
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Arend Bökenkamp
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Long-term glomerular dysfunction after childhood cancer nephrectomy: what is the impact of nephrectomy and obesity? Kidney Int 2023; 103:226-227. [PMID: 36603972 DOI: 10.1016/j.kint.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
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