Retroperitoneal Laparoscopic Resolution of Posas Abscess: Case Reports and Review of the Literature.

INTRODUCTION: Psoas abscess is a rare pathological entity being retroperitonescopy an unusual therapeutic modality for its resolution. MATERIALS AND METHODS: The objective is to present and describe five patients with a diagnosis of psoas abscess that were resolved by retroperitoneoscopy in our institution and then carried out a non-systematic review of the literature. RESULTS: The mean age was 58.8 years and 80% were male. All patients had back pain and none had therapeutic resolution with conservative treatment. 60% of the patients had a methicillin sensitive Staphyylococus Aureus. In the follow-up with a mean of 10.2 months, no recurrence was observed. CONCLUSIONS: Early diagnosis of psoas abscess is important for its correct resolution. In our small series of patients, retroperitoneoscopy was an effective treatment.

Analysis of Trifecta Results in a Single-Center Experience with Retroperitoneoscopic Partial Nephrectomy: An Observational Study.

OBJECTIVE: To analyze the trifecta results in patients with T1a and T1b renal tumors treated with retroperitoneoscopic partial nephrectomy (RPN). MATERIAL AND METHODS: A cross-sectional prospective observational study was conducted on 106 patients with cT1 renal tumor submitted to RPN. Trifecta was reported as no ≥ 2 Clavien-Dindo complications, warm ischemia time (WIT) ≤ 25 minutes, ≤ 15% postoperative ΔGFR, and nonpositive margins. RESULTS: The mean age was 58 years (SD ± 12). The median (Q1; Q3) tumor size was 3.5 (2.2; 4.5) cm. Of the treated patients, 33% had a ventral tumor. R.E.N.A.L nephrometry score was low complexity in 54% of cases and high complexity in 4%. WIT median (Q1; Q3) was 20 (14; 23) minutes. Estimated blood loss median (Q1; Q3) was 50 (0; 100) ml. There were no conversions to open surgery. ΔGFR was >15% in 17.5% of patients. There were no postoperative complications in 84% of cases. Nonpositive margins were observed. Sixty-eight percent were pT1a and 32% were pT1b. Seventy-two percent of patients presented trifecta. A statistically significant difference was found between trifecta and tumor size (3 cm vs. 4.4 cm; p<0.001), complexity (low complexity 90% vs. intermediate complexity 56%; p<0.0001), and pT (T1a 81% vs. T1b 53%; p<0.003). CONCLUSION: RPN is a safe and effective treatment modality for T1a and T1b renal tumors. Trifecta rate was 72%. Tumor size, tumor complexity, and pT were found to be an associated factor for trifecta.

[Laparoscopic adenomectomy versus open adenomectomy: A comparative study.] / Adenomectomía simple laparoscópica versus adenomectomía simple abierta: un estudio comparativo.

INTRODUCTION: The improvements in laparoscopic urological surgery have made laparoscopic adenomectomy (LA) possible in voluminous prostatic adenomas. OBJECTIVE: The objective of this study was to assess the results of the LA and compared them with results of the open adenomectomy (OA). MATERIAL AND METHODS: A comparative study of 41 patients undergoing LA [23 LA with Millin technique (LA-MT) and 21 with transvesical technique (LA-TV)] was conducted with 44 patients undergoing OL in prostate adenomas > 100 grams. Data were recorded prospectively, at three different institutions. Preoperative, intraoperative, postoperative and complications results were evaluated. RESULTS: Prostate volume was 165 (100-345) gr for LA versus 170 (100-328) gr for OA (p=0.669). Preoperative IPSS was 3 (0-3) and Q max. 7 (0-15) for LA against 2 (0-3) and 7 (0-15.3) for OA (p=0.296;p=0.316). There was no difference in surgical time (p=0.069) between both techniques. LA had less operative bleeding, 100 (10-1000) ml than OA, 500 (100-1000) ml (p=0.0001) and a shorter hospital stay, 3 (1-8) days against 3.5 (3-10) days (p=0.0001), postoperative IPSS was 1 (1-2) and Q max. 25 (17-45) for LA against 1 (1-3) and 25.5 (12-44) for OA (p=0889;p=836). There were no differences neither in transfusions requirements' nor complications. CONCLUSION: LA presented similar short-term functional results with less operative bleeding and shorter hospitalization time than OA with similar prostate volumes resected.

INTRODUCCIÓN: Los avances en la cirugía laparoscópica urológica han permitido la realización de la adenomectomía simple laparoscópica (ASL) en adenomas prostáticos voluminosos. OBJETIVO: El objetivo de este estudio fue evaluar los resultados de la ASL y compararlos con la adenomectomía simple abierta (ASA). MATERIAL Y METODOS: Se realizó un estudio comparativo de 41 pacientes sometidos a ASL [23 ASL con técnica de Millin (ASL-TM) y 21 con técnica transvesical (ASL-TV)] con 44 pacientes sometidos a ASA en adenomasde próstata > 100 gramos. Los datos se registraron de modo prospectivo, en tres centros diferentes. Se evaluaron los resultados preoperatorios, operatorios, postoperatorios y complicaciones según escala de Clavien. RESULTADOS: El volumen prostático fue 165 (100-345) gr para ASL contra 170 (100-328) gr para ASA (p=0,669). IPSS preoperatorio 3 (0-3) y Q máx. 7 (0-15) para ASL contra 2 (0-3) y 7 (0-15,3) para ASA (p=0,296; p=0,316). No hubo diferencia tiempo quirúrgico (p=0,069). ASL tuvo menos sangrado operatorio100 (10-1000) ml que la ASA 500 (100-1000) ml (p=0,0001) y una menor estadía hospitalaria 3 (1-8) días contra 3,5 (3-10) días (p=0,0001), IPSS postoperatorio1 (1-2) y Q máx. 25 (17-45) para ASL contra 1(1-3) y 25,5 (12-44) para ASA (p=0889; p=836). No hubo diferencias en el requerimiento de transfusiones ni complicaciones.CONCLUSIÓN: La ASL presentó similares resultados funcionales a corto plazo con un menor sangrado operatorio y tiempo de hospitalización que la ASA y una baja tasa de complicaciones a similares volúmenes prostáticos resecados.