Speaking to mediapersons on Monday, the team, comprising cardiologist Dr K V Muralidharan, paediatric urologist Dr V Sripathi and anaesthetist Dr S Ramesh of the Childs Trust Hospital, said only 23 such surgeries have been successful all over the world.

Six per cent of all kidney tumours in children, between three and eight years of age, is the Wilm tumour. The tumour grows along the vital organs via the inferior vena cava which takes the blood back to the heart.

In both cases the tumour had manifested on the kidney and had grown through the blood vessel. If the tumour in Prithviraj had been undetected it could have passed through the heart and into the lungs thereby reducing the success rate removing it toless than 10 per cent. Eventually, he would have been unable to breathe, Muralidharan said.

Prithviraj, who hails from Namakkal where his father is a truck fleet owner, had the tumour in his right kidney which had extended to his heart and liver. He was very sick on arrival and had a very low appetite. After the tumour had been shrunk with chemotherapy, the child underwent a seven-hour long combined open cardiac and abdominal surgery.

Anaesthesia proved another challenge. Morphine, if used in higher doses could affect the respiratory process, said Ramesh, adding that the child had to be given morphine only for the surgery.

In post-operative care, he was administered epidoral analgesia from the back. This procedure is used on women during labour.

The seven-hour long surgery involved extreme caution and speedy work. Prithviraj had to undergo seven months of chemotherapy to kill the minute parts of the tumour which could have remained. He is hale and hearty and will undergo two more months ofchemotherapy, Muralidharan said. He is now attending school.

The operation cost Rs 1.3 lakh with most of the expenditure going towards consumables. Consultant oncologist Dr R Varadarajan is heading a team providing post-operative chemotherapy.

However, in the case of Padma the operation, on November 30, had to be done free of cost. The child of an agricultural labourer in Nellore, she was operated upon by a team comprising Muralidharan, N Prasad, D Soundararajan and S Ramesh.

Padma had another complication -- the tumour had stuck to the venal wall. After removing it from the vena cava, tissue from her heart was taken and placed at the spot where the venal tissues had been displaced in the process. She has to undergo chemotherpay for a year.

Both the children are ready to face life with one kidney less, the doctors said.