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Paediatric Surgery in Fiji - Pacific Paediatric Oncology Conference 2016

Paediatric Surgery in Fiji - Pacific Paediatric Oncology Conference 2016. Dr. Josese Turagava. Oncological Surgeons. Pediatricians Community Support groups. Nurses & oncologists Pharmacists. Radiologists Pathologists. Paediatric Surgical oncology. Layout. Case studies Strategy

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Paediatric Surgery in Fiji - Pacific Paediatric Oncology Conference 2016

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  1. Paediatric Surgery in Fiji-Pacific Paediatric Oncology Conference 2016 Dr. Josese Turagava

  2. Oncological Surgeons Pediatricians Community Support groups Nurses & oncologists Pharmacists Radiologists Pathologists Paediatric Surgical oncology

  3. Layout • Case studies • Strategy • How we do it • Strengths • Sustainability –workforce planning • Transformation at National level

  4. J. S - 2006 • 3 years old Indo-Fijian male from Ba • Presented to Lautoka Hospital in July for a right testicular swelling (orchidectomy – mature teratoma) and an abdominal mass • Mass was from the RUQ to umbilicus level • Non-tender and ballotable

  5. CT films:

  6. Pre – Chemo (Neoadjuvant )

  7. Post. op • Completed 6 cycles of chemo and has recovered very well

  8. J. T - 2007 • 1year 5/12 old Fijian girl • Mother noticed abdominal mass since 9/12 • Painless • Otherwise normal

  9. Examination: • Mass left side of upper abdomen to umbilical region • Non-tender • ballotable

  10. Abdominal X-Ray:

  11. CT with contrast:

  12. Lt. nephrectomy done • Child recovered well post op • completed Chemotherapy once /month x 6 cycles • Child is well

  13. K. T - 2007 • 5 years old Vanuatu girl • Right Abdominal mass x 3 years • Dysuria x 1 year • Haematuria x 1 year

  14. CT with contrast:

  15. Treatment: • Neo-adjuvant chemotherapy April 2006 • Radical nephrectomy June 2006 • Post chemotherapy x 6 /12 • Developed secondary metastasis in November & died

  16. CXR : on admission, 1/12 post Rx.

  17. 9/12 post admission & 11/12

  18. I. T -2007 • Born:8/10/07 • Abd. Swelling from birth • Referred to CWMH Wednesday with distended abdomen

  19. child

  20. CT films

  21. Retroperitoneal tumour 2008

  22. Retroperitoneal Teratoma

  23. Wilms 2015

  24. Hepatoblastoma 2015

  25. Post resection

  26. A.L -Non Hodgkins - 2016

  27. Burkitt’s Lymphoma –June 2016

  28. Bleeding ruptured ovaries

  29. Mesenteric component

  30. En bloc resection

  31. Ovarian tumour –Nov2016

  32. Thoracic tumour 2016

  33. Group of patients • Local capacity • Need to go overseas – beyond our local capacity • Work up the patient locally and await visiting team • Emergency – bleeding/ compartment syndrome

  34. Strength! • Team approach • Surgery – where? • Do we have the local capacity? • Beyond local capacity? • Local capacity building during visiting teams • Visiting team – 2 times per year ( includes radiologist/ pathologist) • Backup – Jitoko, Kiki, Phil, Vipul

  35. Workforce planning • Save – completing training in end of 2017 • (Annette/ Colin - still not sure?)

  36. Spin off • Forerunner for oncology services in Fiji • Model that adult oncology is trying to copy

  37. Pacific Paediatric Oncology Society 2007

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