Surgery for Wilms Tumor

Most children who are diagnosed with a Wilms tumor have it in just one kidney. Doctors at NYU Langone typically remove the tumor during surgery at the time of diagnosis.

If a child has a large tumor, doctors may need to remove the entire kidney during a surgery called a nephrectomy.

When cancer cells break away from a tumor, they may travel to other parts of the body through the lymph nodes—small glands located throughout the body that filter fluid from tissues and assist in trapping viruses and bacteria. Your child’s surgeon removes lymph nodes near the kidney, and a pathologist analyzes them under a microscope to determine if the cancer has spread, or metastasized. This helps doctors determine the best treatment.

If imaging tests show that the tumor is large or has spread to other parts of the body, doctors may recommend chemotherapy before surgery to shrink the tumor and destroy cancer cells.

Radical Nephrectomy

A radical nephrectomy is the removal of a kidney, the tumor, and nearby lymph nodes. Surgeons at NYU Langone use this procedure for children with a large Wilms tumor confined to one kidney.

In this surgery, a doctor makes an incision in the abdomen and removes the tumor, the kidney, the fatty tissue that surrounds the kidney, the adrenal gland, and the ureter, the tube that carries urine from the kidney to the bladder. The remaining kidney is typically able to provide adequate waste filtering for the body.

Rarely, both kidneys must be removed. This occurs when there are large tumors in both kidneys. In this case, children need dialysis, which uses machines to do the kidneys’ job of filtering waste from the blood. A kidney transplant may be an option for children who are healthy enough for one.

Partial Nephrectomy

For children with Wilms tumors in both kidneys, the surgeon may perform a partial nephrectomy. Rarely used, this procedure, called nephron-sparing surgery, involves removing the tumors and a margin of tissue surrounding them to ensure that all the cancer cells are gone.

Managing Side Effects

Surgery can cause short-term side effects, including swelling at the incision site and pain. Our specialists provide children who have had surgery with pain medications to keep them comfortable while healing.