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Revista mexicana de urologia最新文献

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Terapia de inducción bacillus Calmette-Guérin: en búsqueda del esquema ideal calmette - guerin芽孢杆菌诱导疗法:寻找理想方案
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.09.007
E. Linden-Castro, M. Pelayo-Nieto
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引用次数: 0
Tratamiento laparoscópico de las fístulas colovesicales: experiencia preliminar 胆囊瘘的腹腔镜治疗:初步经验
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.09.006
J.A. Zapata-González , V. Corona-Montes , E.A. Ramírez-Pérez , D. López-Alvarado

Background

Diverticular disease of the colon is common in the western world. After the first episode of diverticulitis, many patients benefit from medical therapy, but 10-20% develop abscesses, obstruction, or fistula.

Aim

To describe the laparoscopic treatment of sigmoidovesical fistula secondary to diverticular disease.

Material and methods

An observational, retrospective study was conducted on 10 consecutive patients within the time frame of 2011-2015 that had undergone: 1) colovesical fistula resection and primary closure of the bladder and sigmoid colon or 2) laparoscopic sigmoidectomy with the NOSE technique (transanal extraction of the specimen and colorectal anastomosis with primary closure of the bladder).

Results

Ten patients were operated on within the time frame of February 2011 and February 2015. The mean age of the patients was 60.7(49-71) years. Sigmoidectomy with primary anastomosis was performed on 4 patients and resection and primary closure on 6 patients. Surgery duration was 140.4 (80-210) min, blood loss was 195 (80-210) ml, and length of time before beginning oral diet was 4.3 (3–5) days. The drain was left in place in all the patients for 10 days and the transurethral catheter for 2 weeks. Up to the present time, none of the patients has presented with fistula recurrence or data consistent with intestinal anastomosis stricture.

Conclusions

Reports on the use of laparoscopy for the treatment of colovesical fistulas have demonstrated acceptable results. Only a few studies concentrate exclusively on colovesical fistula; in general the reports include other types of fistula (colovaginal and colocutaneous), as well. Colovesical fistula is a pathology that can be resolved safely and efficaciously through laparoscopy.

背景结肠憩室病在西方世界很常见。在首次憩室炎发作后,许多患者从药物治疗中获益,但10-20%的患者出现脓肿、梗阻或瘘管。目的探讨乙状结肠憩室病继发乙状囊瘘的腹腔镜治疗方法。材料与方法对2011-2015年连续10例患者进行观察性、回顾性研究:1)结肠瘘管切除术及膀胱乙状结肠一期闭合术或2)腹腔镜乙状结肠切除术及鼻技术(经肛门标本取出及结肠吻合术,一期闭合膀胱)。结果10例患者于2011年2月至2015年2月间手术。患者平均年龄为60.7(49 ~ 71)岁。乙状结肠切除一期吻合4例,乙状结肠切除一期吻合6例。手术时间140.4 (80-210)min,出血量195 (80-210)ml,开始口服饮食时间4.3 (3-5)d。所有患者均留置引流管10天,留置经尿道导尿管2周。截至目前,无一例患者出现瘘口复发或吻合肠吻合口狭窄的资料。结论使用腹腔镜治疗膀胱瘘的报告显示了可接受的结果。只有少数研究集中在膀胱瘘;一般来说,报告也包括其他类型的瘘(阴道瘘和皮肤瘘)。膀胱瘘是一种可以通过腹腔镜安全有效地解决的病理。
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引用次数: 2
Climacturia posterior a la prostatectomía radical 根治性前列腺切除术后的更年期
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.08.003
A. Monroy-Galvez , L.A. Jimenez-López , H.R. Vargas-Zamora , D. Rios-Cruz

Background

To know the frequency, associations, and impact of climacturia on the function of orgasm after definitive surgical treatment of prostate cancer in Mexican patients.

Material and methods

A questionnaire was applied between January 2003 and January 2013 to know the aspects of climacturia (frequency, quantity of urine leakage, mechanisms used by the patient, and the level of discomfort and coping).

Results

A total of 122 patients were selected and 84 met the inclusion criteria. The mean age was 55.3 years. A total of 45.2% of the patients stated that they presented with climacturia, resulting in a prevalence of 0.45. Of those patients, 23.6% said they rarely experienced the condition, 47.3% occasionally, 10.5% often, 13.15% the majority of the time, and 5.26% all the time. In relation to patient satisfaction and negative perception during sexual intercourse, 23 patients stated that it was not a significant problem. Only 9 patients said that it represented an important level of discomfort for their partner.

Conclusions

There is a high number of patients with climacturia following radical prostatectomy and the condition is not necessarily associated with a negative impact on sexual satisfaction.

背景:了解墨西哥前列腺癌患者手术治疗后性高潮的频率、相关性和对性高潮功能的影响。材料与方法于2003年1月至2013年1月采用问卷调查的方式了解患者的尿频、漏尿次数、漏尿机制、不适程度及应对方式。结果共纳入122例患者,符合纳入标准84例。平均年龄为55.3岁。45.2%的患者表示出现更年期,患病率为0.45。在这些患者中,23.6%的人说他们很少经历这种情况,47.3%偶尔,10.5%经常,13.15%大部分时间,5.26%一直。关于患者在性交过程中的满意度和负面感知,23例患者表示这不是一个显著的问题。只有9名患者表示,这对他们的伴侣来说是一个重要的不适程度。结论根治性前列腺切除术后出现更年期的患者数量较多,其对性满意度的影响并不一定是负面的。
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引用次数: 1
Gama-glutamil trasferasa en suero, adyuvante del antígeno prostático específico en el diagnóstico del cáncer de próstata 血清-谷氨酰胺转移酶,前列腺特异性抗原佐剂在前列腺癌诊断中的作用
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.08.004
M. Díaz-Pérez , M.A. Hernández-Manzanares , V. Montes-Martínez , E.A. Sánchez-Valdivieso

Objective

The aim of this study was to determine the relation of prostate-specific antigen to histopathologic and biochemical indicators in patients with a clinical prostate cancer diagnosis.

Material and methods

A cross-sectional study was conducted on patients 50 years and older that had a clinical diagnosis of prostate cancer within the time frame of March 2012 and August 2014. Prostate-specific antigen levels and histopathologic and biochemical data were analyzed through descriptive statistics, the Spearman correlation, ROC curves, and contingency tables.

Results

The median age of the patients was 71 years and the median prostate-specific antigen value was 8.1 ng/ml (2 ng/ml to 3,685 ng/ml). Pathologic study confirmed prostate cancer diagnosis in 50 patients. There was an association between prostate-specific antigen levels and Gleason score (p < 0.05), as well as between prostate-specific antigen and gamma-glutamyl transferase (p < 0.05).

Conclusions

Gamma-glutamyl transferase determination is suggested for increasing prostate-specific antigen sensitivity and specificity. The number of patients was a limitation of our study.

目的探讨前列腺特异性抗原与临床诊断前列腺癌患者组织病理及生化指标的关系。材料与方法对2012年3月至2014年8月期间50岁及以上临床诊断为前列腺癌的患者进行横断面研究。通过描述性统计、Spearman相关、ROC曲线和列联表分析前列腺特异性抗原水平和组织病理生化数据。结果患者年龄中位数为71岁,前列腺特异性抗原中位数为8.1 ng/ml (2 ~ 3685 ng/ml)。病理研究证实了50例患者的前列腺癌诊断。前列腺特异性抗原水平与Gleason评分之间存在相关性(p <0.05),前列腺特异性抗原与γ -谷氨酰转移酶之间(p <0.05)。结论-谷氨酰转移酶检测可提高前列腺特异性抗原的敏感性和特异性。患者的数量是我们研究的一个限制。
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引用次数: 1
Tejido suprarrenal ectópico en saco herniario inguinal 腹股沟疝囊异位肾上腺组织
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.09.002
F. Ugarte y Romano , A. González-Serrano

Adrenal tissue ectopia is uncommon. Its incidence in adults is not known, but there are 9 case reports in the international medical literature on ectopic adrenal tissue in the hernial sac.

We present herein 2 cases of ectopic adrenal tissue in the hernial sac of the spermatic cord, reviewing its pathogenesis, and attempting to justify the medical importance of its report in the literature.

Two men in the third decade of life underwent left inguinal hernioplasty and varicocelectomy with a histopathologic report of adrenal tissue nodules along the extension of spermatic cord lipoma.

Despite the low frequency of these cases, extirpation of the ectopic tissue is recommended, given that cases of neoplasia and endocrinologic complications due to this type of ectopia have been documented.

肾上腺组织异位并不常见。其在成人中的发病率尚不清楚,但在国际医学文献中有9例关于疝囊内肾上腺组织异位的报道。我们在此报告2例精索疝囊内肾上腺组织异位,回顾其发病机制,并试图证明其文献报道的医学重要性。两名30岁的男性接受了左侧腹股沟疝成形术和精索静脉曲张切除术,组织病理学报告显示肾上腺组织结节沿精索脂肪瘤延伸。尽管这些病例的发生率很低,但鉴于这种类型的异位引起的肿瘤和内分泌并发症的病例已被记录在案,建议切除异位组织。
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引用次数: 0
Hidronefrosis bilateral e incontinencia urinaria de esfuerzo secundario a prolapso de órganos pélvicos grado iv: manejo laparoscópico 双侧肾盂积水和继发性尿失禁盆腔器官脱垂iv级:腹腔镜治疗
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.09.004
J. Padilla Piña, A. García Vásquez Roberto, J. Arriaga Aguilar, R. Vega Castro, M. Pérez Manzanares Víctor, A. Zárate Morales, I. Gerardo Osuna, M. Garcia Díaz, T. Cascajares Murillo, A. Vazquez Galvez

Pelvic organ prolapse is not a life-threatening condition, but it alters the quality of life in women. A woman has an 11% possibility of having pelvic floor dysfunction during her lifetime that will require surgical treatment. The main etiology is complex and multifactorial. We present herein the case of a woman with grade IV pelvic organ prolapse plus stress urinary incontinence. Physical examination revealed bladder prolapse at 6 cm below the vaginal introitus and a positive Marshall test. Computed axial tomography (CAT) identified hydronephrosis of the right kidney, dilated ureters, and a bladder, uterus, and rectum that dropped beyond the vaginal canal. Hysterectomy plus laparoscopic colposacropexy plus anterior and posterior colpoperineoplasty with polypropylene sling placement were performed. Surgery duration was 300 min, blood loss was 95 ml, and hospital stay was 2 days. The Marshall test was negative 60 days after the operation and control CAT scan showed there was no hydronephrosis.

Laparoscopic colposacropexy had become the criterion standard for vaginal prolapse management because it achieves anatomic recovery and lasting urinary, intestinal, sexual, and psychosocial function.

盆腔器官脱垂不是危及生命的疾病,但它会改变女性的生活质量。女性一生中有11%的可能性患有盆底功能障碍,需要手术治疗。主要病因复杂,多因素。我们在此提出的情况下,妇女与IV级盆腔器官脱垂加压力性尿失禁。体格检查发现膀胱脱垂于阴道开口下6cm处,马歇尔试验阳性。计算机轴位断层扫描(CAT)发现右肾肾积水、输尿管扩张、膀胱、子宫和直肠落在阴道管外。行子宫切除术加腹腔镜阴道背固定术加聚丙烯吊带置放前后阴道背成形术。手术时间300 min,出血量95 ml,住院时间2 d。术后60天马歇尔试验为阴性,对照CAT扫描显示无肾积水。腹腔镜阴道悬垂术已成为阴道脱垂治疗的标准,因为它可以实现解剖恢复和持久的泌尿、肠道、性和社会心理功能。
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引用次数: 0
Reconstrucción peniana y resección de linfedema de pene 阴茎重建和阴茎淋巴水肿切除
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.08.002
F. Ugarte y Romano , A. González-Serrano

Genital lymphedema has generally been treated through plastic and reconstructive surgery.

The aim of this article was to present an alternative technique for the functional and esthetic treatment of penile lymphedema with a urologic approach.

A male patient had a past history of left testicular tumor, left radical orchiectomy, inguinoscrotal radiotherapy, secondary penile and scrotal lymphedema, and a left inguinal reservoir to palliate the scrotal lymphedema. He presented with an important deformation of the penis, micturition difficulty, and repeat balanoposthitis and so the decision was made to perform resection of the penile lymphedema and the corresponding reconstruction.

There were no complications during or after the procedure and good cicatrization and reduced penile lymphedema were observed.

The different conservative as well as surgical treatments that exist offer variable results. The management of these techniques is important for the urologist so that an integrated approach with other specialists can be carried out that will provide the patient with the best results.

生殖器淋巴水肿一般通过整形和重建手术治疗。这篇文章的目的是提出一个替代技术的功能和美学治疗阴茎淋巴水肿与泌尿外科途径。男性患者既往有左侧睾丸肿瘤,左侧根治性睾丸切除术,腹股沟-阴囊放射治疗,继发性阴茎和阴囊淋巴水肿,左侧腹股沟蓄水池缓解阴囊淋巴水肿。患者表现为阴茎严重变形,排尿困难,反复出现阴茎阴部炎,故决定行阴茎淋巴水肿切除重建术。术中术后均无并发症,结痂良好,阴茎淋巴水肿减少。不同的保守和手术治疗提供了不同的结果。这些技术的管理对泌尿科医生来说很重要,以便与其他专家进行综合治疗,为患者提供最好的结果。
{"title":"Reconstrucción peniana y resección de linfedema de pene","authors":"F. Ugarte y Romano ,&nbsp;A. González-Serrano","doi":"10.1016/j.uromx.2015.08.002","DOIUrl":"10.1016/j.uromx.2015.08.002","url":null,"abstract":"<div><p>Genital lymphedema has generally been treated through plastic and reconstructive surgery.</p><p>The aim of this article was to present an alternative technique for the functional and esthetic treatment of penile lymphedema with a urologic approach.</p><p>A male patient had a past history of left testicular tumor, left radical orchiectomy, inguinoscrotal radiotherapy, secondary penile and scrotal lymphedema, and a left inguinal reservoir to palliate the scrotal lymphedema. He presented with an important deformation of the penis, micturition difficulty, and repeat balanoposthitis and so the decision was made to perform resection of the penile lymphedema and the corresponding reconstruction.</p><p>There were no complications during or after the procedure and good cicatrization and reduced penile lymphedema were observed.</p><p>The different conservative as well as surgical treatments that exist offer variable results. The management of these techniques is important for the urologist so that an integrated approach with other specialists can be carried out that will provide the patient with the best results.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117353644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experiencia inicial en prostatectomía radical laparoscópica
Q4 Medicine Pub Date : 2015-11-01 DOI: 10.1016/j.uromx.2015.09.001
S. Collura-Merlier, C. Reyes-Utrera, J.O. Herrera-Cáceres, J.M. Ochoa-López, J.A. Rivera-Ramírez, H. Sandoval-Barba, B. Gabilondo-Pliego

Background

The era of prostate-specific antigen screening has produced an increase in the incidence of localized prostate cancer. Radical surgery is the gold standard for patients that are candidates for curative tratment.

Aim

To describe the initial experience with laparoscopic radical prostatectomy (LRP) at a tertiary care referral center.

Material and method

The cohort of patients that underwent radical prostatectomy within the time frame of January 2013 to June 2015 was reviewed. Eleven patients that underwent LRP, all operated on by the same surgeon, were included in the study. Demographic variables, comorbidities, and preoperative, intraoperative, and postoperative variables were analyzed. Biochemical recurrence and surgical margins were the oncologic variables evaluated. Descriptive statistics using the SPSS® version 20 statistical software package were carried out, performing frequency, means plus standard deviation, and median with range analyses.

Results

The mean age of the patients was 62.7 years with a standard deviation of ± 7.3. The majority of the presurgical cases were low-risk. A presurgical understaging trend was observed, given that 33% of patients were classified as high-risk after LRP. Follow-up time was 8 months (± 3.1). Two laparoscopic surgeries were converted for the surgeon's convenience to perform urethrovesical anastomosis. Blood loss, surgery duration, and hospital stay means were 380 ml (240-2,500), 300 min (105-615), and 4 days (3-10), respectively. The transfusion rate was 18% and the mean time with transurethral catheter was 7.9 days (6-9.7). Bilateral nerve-sparing surgery was performed in 100% of the cases. Urinary continence was achieved in 72.7% of the cases at one month after surgery, with an improvement trend from the third month to one year of follow-up. Erectile function was preserved in 55% of the cases and the positive margin rate was 45%. Prostate-specific antigen was undetectable at one month after LRP in 64% of the cases. The so-called trifecta outcome was met at one month after surgery in 36% of the patients and an incidence of 18% was reported in relation to postoperative complications.

Conclusions

We presented the initial experience with LRP at our hospital. LRP appears to be a safe technique with acceptable functional and oncologic results. Ours is a first series that must be updated as the learning curve moves closer to reaching its final plateau.

背景:前列腺特异性抗原筛查的时代使得局限性前列腺癌的发病率增加。根治性手术是治疗候选者的金标准。目的描述三级保健转诊中心腹腔镜根治性前列腺切除术(LRP)的初步经验。材料与方法回顾性分析2013年1月至2015年6月期间行根治性前列腺切除术的患者。11名接受LRP手术的患者都是由同一位外科医生进行的,他们被纳入了研究。统计变量、合并症、术前、术中、术后变量进行分析。生化复发和手术切缘是评估的肿瘤变量。使用SPSS®version 20统计软件包进行描述性统计,进行频率、均值加标准差、中位数和极差分析。结果患者平均年龄为62.7岁,标准差为±7.3。大多数手术前病例是低风险的。考虑到33%的患者在LRP后被归为高风险,我们观察到手术前分期不足的趋势。随访时间8个月(±3.1)。为方便外科医生行膀胱输尿管吻合术,将两例腹腔镜手术改为膀胱输尿管吻合术。出血量、手术时间和住院时间分别为380毫升(240- 2500)、300分钟(105-615)和4天(3-10)。输注率为18%,平均使用时间为7.9天(6 ~ 9.7天)。所有病例均行双侧神经保留手术。术后1个月尿失禁率为72.7%,随访3个月至1年有改善趋势。55%的病例勃起功能得以保留,阳性边缘率为45%。在LRP后一个月,64%的病例检测不到前列腺特异性抗原。36%的患者在术后一个月达到了所谓的三合一结果,18%的患者报告了与术后并发症有关的发生率。结论介绍了我院LRP治疗的初步经验。LRP似乎是一种安全的技术,具有可接受的功能和肿瘤结果。我们是第一个必须更新的系列,因为学习曲线越来越接近最终平台。
{"title":"Experiencia inicial en prostatectomía radical laparoscópica","authors":"S. Collura-Merlier,&nbsp;C. Reyes-Utrera,&nbsp;J.O. Herrera-Cáceres,&nbsp;J.M. Ochoa-López,&nbsp;J.A. Rivera-Ramírez,&nbsp;H. Sandoval-Barba,&nbsp;B. Gabilondo-Pliego","doi":"10.1016/j.uromx.2015.09.001","DOIUrl":"10.1016/j.uromx.2015.09.001","url":null,"abstract":"<div><h3>Background</h3><p>The era of prostate-specific antigen screening has produced an increase in the incidence of localized prostate cancer. Radical surgery is the gold standard for patients that are candidates for curative tratment.</p></div><div><h3>Aim</h3><p>To describe the initial experience with laparoscopic radical prostatectomy (LRP) at a tertiary care referral center.</p></div><div><h3>Material and method</h3><p>The cohort of patients that underwent radical prostatectomy within the time frame of January 2013 to June 2015 was reviewed. Eleven patients that underwent LRP, all operated on by the same surgeon, were included in the study. Demographic variables, comorbidities, and preoperative, intraoperative, and postoperative variables were analyzed. Biochemical recurrence and surgical margins were the oncologic variables evaluated. Descriptive statistics using the SPSS® version 20 statistical software package were carried out, performing frequency, means plus standard deviation, and median with range analyses.</p></div><div><h3>Results</h3><p>The mean age of the patients was 62.7 years with a standard deviation of<!--> <!-->±<!--> <!-->7.3. The majority of the presurgical cases were low-risk. A presurgical understaging trend was observed, given that 33% of patients were classified as high-risk after LRP. Follow-up time was 8 months (±<!--> <!-->3.1). Two laparoscopic surgeries were converted for the surgeon's convenience to perform urethrovesical anastomosis. Blood loss, surgery duration, and hospital stay means were 380<!--> <!-->ml (240-2,500), 300<!--> <!-->min (105-615), and 4 days (3-10), respectively. The transfusion rate was 18% and the mean time with transurethral catheter was 7.9 days (6-9.7). Bilateral nerve-sparing surgery was performed in 100% of the cases. Urinary continence was achieved in 72.7% of the cases at one month after surgery, with an improvement trend from the third month to one year of follow-up. Erectile function was preserved in 55% of the cases and the positive margin rate was 45%. Prostate-specific antigen was undetectable at one month after LRP in 64% of the cases. The so-called trifecta outcome was met at one month after surgery in 36% of the patients and an incidence of 18% was reported in relation to postoperative complications.</p></div><div><h3>Conclusions</h3><p>We presented the initial experience with LRP at our hospital. LRP appears to be a safe technique with acceptable functional and oncologic results. Ours is a first series that must be updated as the learning curve moves closer to reaching its final plateau.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123313270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acceso percutáneo al cáliz superior en posición supina: experiencia inicial 仰卧位经皮进入上杯:初步经验
Q4 Medicine Pub Date : 2015-09-01 DOI: 10.1016/j.uromx.2015.06.008
J.A. Zapata-Gonzalez , E.A. Ramirez-Pérez , D. López-Alvarado , J. Corona-Martinez

Background

The correct choice for the percutaneous puncture site is key to the success of any percutaneous nephrolithotomy. The ideal puncture should maximize the effectiveness of the procedure in terms of stone-free rate and minimize the risk for complications. It is necessary to correctly choose the calyx to be accessed; in certain cases the upper calyx is the ideal site.

Aims

To report our experience with the percutaneous approach to the upper pole with patients in the supine position.

Methods

A retrospective, observational, descriptive study was carried out on patients with stones in the renal pelvis or upper calyx treated through percutaneous nephrolithotomy.

Results

A total of 17 patients were included in the study, and 17 kidney units were treated. All 17 patients (100%) underwent general anesthesia. Nine (53%) of the patients were men and 8 (47%) were women, with a mean age of 45.8 years (range: 18-72). Stone site was the right kidney in 10 (59%) patients and the left in 7 (41%). A total of 13 (76%) patients were symptomatic. The mean body mass index was 27 kg/m2 (range: 20-34). ASA classification was I in 13 (76.4%) patients, II in 3 (17.6%) patients, and III in one (5.8%) patient. Eight (47%) patients underwent previous treatments. Procedure success or stone-free rate was achieved in 14 (82.3%) patients with the first treatment and in 17 (100%) with the second treatment.

Discussion

Current knowledge of the pleural and diaphragmatic anatomy, the use of real time ultrasound for percutaneous puncture, and the development of new surgical techniques have considerably reduced the risk for intrathoracic complications.

Conclusions

Access to the upper calyx with the patient in the supine position is safe and reproducible. This approach provides excellent vision of the entire pyelocaliceal system and should be reserved for cases in which the lower calyx is not the best option.

背景:正确选择经皮肾镜穿刺位置是任何经皮肾镜取石手术成功的关键。理想的穿刺应在结石清除率和并发症风险方面最大限度地提高手术效果。正确选择要接触的花萼是必要的;在某些情况下,上花萼是理想的位置。目的报告我们对仰卧位患者经皮入路上极的经验。方法对经皮肾镜取石术治疗肾盂或肾盂上盏结石的患者进行回顾性、观察性、描述性研究。结果共纳入17例患者,治疗17个肾单位。17例患者(100%)均行全身麻醉。男性9例(53%),女性8例(47%),平均年龄45.8岁(18-72岁)。结石部位为右肾10例(59%),左肾7例(41%)。共有13例(76%)患者出现症状。平均体重指数为27 kg/m2(范围:20-34)。ASA分级为I级13例(76.4%),II级3例(17.6%),III级1例(5.8%)。8例(47%)患者曾接受过治疗。第一次治疗14例(82.3%)患者手术成功,第二次治疗17例(100%)患者手术成功。目前对胸膜和膈解剖的了解,实时超声经皮穿刺的使用,以及新的手术技术的发展,大大降低了胸内并发症的风险。结论患者仰卧位取上肾花萼安全、可重复性好。这种方法提供了整个肾盂局部系统的良好视野,应该保留在下花萼不是最佳选择的情况下。
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引用次数: 1
Linfadenectomía inguinal robot asistida (LIRA) para cáncer de pene
Q4 Medicine Pub Date : 2015-09-01 DOI: 10.1016/j.uromx.2015.06.006
V.E. Corona-Montes , E. Moyo-Martínez , L. Almazán-Treviño , V. Ríos-Dávila , Y. Santiago-Hernández , E.E. Mendoza-Rojas

Introduction

Squamous cell carcinoma is a rare tumor, making up from 2 to 5% of the urogenital tumors. However, because our hospital is a referral center that manages large numbers of patients, approximately 5-7 cases are seen per year. Inguinal lymph node dissection is one of the treatments for these lesions and is being performed more frequently as a minimally invasive procedure.

Objective

Our aim was to describe the surgical technique for robotic-assisted inguinal lymphadenectomy in cancer of the penis. We present herein the case of a 73-year-old man with symptom progression of one year and 6 months and increased volume at the level of the glans penis. A biopsy was taken, after which he underwent radical penectomy with perineal urethrostomy. The histopathologic study reported well differentiated verrucous squamous cell carcinoma that invaded the corpus spongiosum and the urethra (T3N0M0G1). Four weeks later he underwent robotic-assisted inguinal lymphadenectomy of the superficial and deep lymph nodes.

Conclusions

Robotic-assisted inguinal lymphadenectomy, aside from its high cost, is a feasible technique when carried out in specialized centers that reduces morbidity, blood loss, and hospital stay.

鳞状细胞癌是一种罕见的肿瘤,约占泌尿生殖系统肿瘤的2% ~ 5%。然而,由于我们医院是一个管理大量患者的转诊中心,每年大约有5-7例病例。腹股沟淋巴结清扫术是治疗这些病变的一种方法,并且作为一种微创手术越来越常见。目的探讨机器人辅助腹股沟淋巴结切除术治疗阴茎癌的手术技术。我们在此提出一个73岁男性的情况下,症状进展一年零6个月,在阴茎头的水平增加体积。活检后,他接受根治性阴茎切除术和会阴尿道造口术。组织病理学研究报告了侵袭海绵体和尿道的高分化疣状鳞状细胞癌(T3N0M0G1)。四周后,他接受了机器人辅助的腹股沟浅淋巴结和深淋巴结切除术。结论机器人辅助的腹股沟淋巴结切除术,除了成本高外,在专业中心进行是一种可行的技术,可以减少发病率、出血量和住院时间。
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引用次数: 3
期刊
Revista mexicana de urologia
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