1. Types of Pediatric Cancers Requiring Surgery

A. Solid Tumors in the Abdomen & Pelvis

1. Wilms Tumor (Nephroblastoma)
   • Origin: Kidney
   • Treatment: Nephrectomy (kidney removal), sometimes partial kidney removal in smaller tumors.
   • Survival Rate: ~90% with surgery + chemotherapy.
2. Neuroblastoma
   • Origin: Nerve tissue (commonly in the adrenal glands)
   • Treatment: Tumor resection, often combined with chemotherapy.
   • High-risk Cases: May require bone marrow transplant after surgery.
3. Hepatoblastoma & Hepatocellular Carcinoma (Liver Cancer)
   • Origin: Liver
   • Treatment: Liver tumor resection or liver transplant in advanced cases.
4. Rhabdomyosarcoma (Soft Tissue Cancer)
   • Origin: Muscles, tendons, or connective tissues
   • Treatment: Surgery combined with chemotherapy/radiation.

B. Brain & Spinal Cord Tumors

1. Medulloblastoma (Most Common Brain Cancer in Kids)
   • Treatment: Craniotomy & tumor resection, followed by radiation/chemotherapy.
2. Gliomas & Astrocytomas
   • Treatment: Partial or total tumor removal; difficult-to-reach tumors may be treated with targeted therapies.
3. Ependymomas (Brain & Spinal Tumors)
   • Treatment: Surgical removal + radiation therapy for complete eradication.

C. Thoracic (Chest) & Bone Tumors

1. Ewing Sarcoma & Osteosarcoma
   • Origin: Bones (often in arms, legs, or pelvis)
   • Treatment: Limb-sparing surgery or amputation if necessary, followed by chemotherapy.
2. Germ Cell Tumors (Testicular or Ovarian Tumors)
   • Treatment: Surgical removal; chemotherapy in malignant cases.

2. Pediatric Cancer Surgery Techniques

A. Open Surgery (Traditional Surgery)

• Used for large tumors, deep-seated cancers, and complex surgeries like nephrectomy (kidney removal) or hepatectomy (liver tumor removal).

B. Minimally Invasive Surgery (Laparoscopy & Thoracoscopy)

• Used for small, localized tumors to reduce pain, scarring, and recovery time.
• Common in kidney, liver, and ovarian tumors.

C. Limb-Sparing Surgery for Bone Cancers

• In cases of osteosarcoma & Ewing sarcoma, instead of amputation, surgeons remove the affected bone and replace it with an implant or bone graft.

D. Fetal Surgery for Rare Tumors

• Some tumors, like sacrococcygeal teratoma, can be partially treated before birth to improve survival rates.

3. Post-Surgical Care & Recovery

A. Immediate Postoperative Care

• ICU Monitoring: Some children may need ventilator support in complex surgeries.
• Pain Management: Medications to ensure comfort.
• Nutritional Support: Some children may need feeding tubes if they cannot eat after surgery.

B. Long-Term Follow-Up

• Physical Therapy: Especially after limb-sparing surgeries or brain tumor removals.
• Regular Scans (MRI/CT/PET): To detect recurrences or complications.
• Psychosocial Support: Counseling for both the child and family.

4. Advances in Pediatric Cancer Surgery

1. Robotic-Assisted Surgery – Offers better precision in delicate areas (e.g., brain & spine tumors).
2. 3D Imaging & AI in Tumor Mapping – Helps plan complex surgeries with greater accuracy.
3. Targeted Therapy & Immunotherapy – Combined with surgery for aggressive cancers.

5. Prognosis & Survival Rates

• Wilms Tumor → ~90% survival with surgery & chemotherapy.
• Neuroblastoma → Early-stage: 95% survival, High-risk: 50-70%.
• Osteosarcoma & Ewing Sarcoma → 60-80% if localized, lower if spread.
• Brain Tumors (Medulloblastoma, Astrocytoma) → 50-80% depending on type & location.