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771.
Introduction Herein, current developments in open and minimally invasive renal surgery are presented.
Materials and methods This also includes considerations on the appropriate indication for the two surgical procedures in small renal tumours, locally
advanced disease (>pT2), complicated renal tumours as well as cytoreductive surgical situations. In small renal tumours, similar
survival rates have been described for laparoscopic radical and partial nephrectomy. However, even experienced high volume
laparoscopic centres report a high learning curve, increased complications and initial technical problems to achieve parenchymal
haemostasis and renal ischaemia during nephron-sparing surgery. Surgical management of large (>T2) or complicated tumours
is feasible, but long-term oncological outcome is not yet available.
Conclusion Promising new developments such as natural orifice translumenal endoscopic surgery (NOTES) might add to our surgical armamentarium
for minimally invasive surgery. 相似文献
772.
McHayleh W Morcos JP Wu T Shapiro R Yousem S Appleman L Friedland DM 《Clinical genitourinary cancer》2008,6(1):53-55
We report 2 cases of renal cell carcinoma (RCC) in which the tumor arose from a transplanted allograft. The first case is a 52-year-old man with a failed cadaveric renal transplantation found to have metastatic RCC. The tumor was proven to be from the allograft, as fluorescence in situ hybridization analysis of biopsy material showed a female karyotype, consistent with his female donor. The second patient is a 45-year-old man who had undergone cadaveric renal transplantation in 1985 for chronic glomerulonephritis and, after 22 years, presented with renal failure. Biopsy and subsequent allograft nephrectomy revealed innumerable microscopic foci of RCC. There are only a few reported cases of RCC arising in kidney allografts and even fewer with reports of metastatic disease from the allograft. Treatments in patients with disease confined to the kidney have included partial nephrectomy and total nephrectomy. A literature search did not find any reports of treatment of metastatic RCC that arose from a renal allograft. 相似文献
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Muhammad Achdiar Raizandha Yudhistira Pradnyan Kloping Fikri Rizaldi 《Radiology Case Reports》2022,17(5):1563
As one of the most commonly injured organs in the genitourinary system during trauma, a thorough understanding of pediatric renal trauma''s diagnosis and management is essential for physicians. The improvement of imaging modalities in recent years has shifted most treatments to a conservative approach. Non-operative management could reduce the risk of nephrectomy while increasing renal salvage rate. However, high-grade pediatric renal injury management remains controversial. We aimed to report two children with high-grade renal trauma, diagnosed using computed tomography and retrograde pyelography studies, undergoing different approaches. The first patient underwent a nephrectomy, whereas the second patient underwent non-operative management. 相似文献
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《Actas urologicas espa?olas》2023,47(4):229-235
ObjectivesThe aim of our study is to demonstrate that the Pfannenstiel incision is a reliable option in terms of postoperative complications compared to other types of incisions usually performed for kidney extraction after laparoscopic nephrectomy.Materials and methodsRetrospective and comparative study of 256 patients who underwent laparoscopic nephrectomy or nephroureterectomy. Patients were divided into two groups: specimen extraction by Pfannenstiel incision (group 1) and specimen extraction by way of other incisions (group 2). Incisional hernia, surgical site infection, pain score, seroma, haematoma/bleeding, wound dehiscence and muscle paralysis were analyzed in each patient.ResultsPatients in Pfannenstiel group presented a rate of wound complications of 11.72% vs 27.34% with other incisions, p = 0.002, it was significantly inferior the rate of wound dehiscence (5.5% vs 12.5%, p = 0.047) and seroma (3.1% vs 7.8%, p = 0.022). Using multivariate logistic regression, Pfannenstiel incision was a significant protective predictor factor for wound complications (OR = 0.34, p = 0.005).ConclusionsThe Pfannenstiel incision allowed the extraction of bigger kidney masses with less incidence of dehiscence, seroma and in general wound complications. The hospital stay was lower in Pfannenstiel extraction group. These results present this incision as a reliable and safe option in the decision of which incision to select. 相似文献
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