Advantages and Short-Term Outcomes of Laparoscopic-Assisted Renal Surgery in Elderly Patients.

OBJECTIVE: To compare the perioperative results of adult and elderly patients undergoing laparoscopic renal surgery. METHODOLOGY: Retrospective, analytical study. 448 who underwent kidney surgery for benign or malignant pathologies between 2011-2019 were included in the General Hospital of Mexico "Dr. Eduardo Liceaga". They were categorized into two groups: Group 1 <60 years and Group 2 >60 years. Descriptive statistics and bivariate analysis were performed, the calculations were performed with 95% reliability and a value of p (<0.05). RESULTS: In the group over 60 years of age, the following was found: Age: 67.1 years (60-83). IMC 28.3 kg/m2 (19-48.7). Intra and postsurgical outcomes: intraoperative bleeding = 184.4cc (5-1700). Surgical Time = 112.6min (30-240). Days of hospital stay = 2 (1-7). Complications in 2.6% (Clavien-Dindo: I = 2; II = 1), no conversion was required in any patient. There were no statistically significant differences with group 1, an exception for intraoperative bleeding. CONCLUSIONS: Our study is a pioneer in Latin America in the evaluation of the geriatric population and outcomes with laparoscopic surgery and we recommend that renal procedures with a laparoscopic approach should be considered as the best strategy in the management of benign or malignant renal pathology in geriatric patients.

Relevancia del antecedente de absceso perirrenal en pacientes sometidos a nefrectomía simple retroperitoneal / Relevance of Perirenal Abscess in Patients undergoing Retroperitoneal Simple Nephrectomy

Las infecciones supurativas del riñón y del espacio perinefrítico son poco comunes, sin embargo, se asocian a una morbimortalidad elevada, afectando a ambos sexos por igual excepto los casos de absceso cortical que es 3 veces más común en el hombre que en la mujer. La incidencia se incrementa con la edad y habitualmente se asocia a uropatía obstructiva. Los abscesos renales representan 0,2% de todos los abscesos intraabdominales, de los cuales el 10% de los abscesos corticales rompen a través de la cápsula formando un absceso perinefrítico, el cual es difícil de manejar y conlleva un peor pronóstico, con una alta mortalidad a pesar de tratamiento quirúrgico oportuno

Supurative infections of the kidney and perinephritic space are rare, however, are associated with high morbidity and mortality, affecting both sexes equally except for cases of cortical abscess which is 3 times more common in men than in women. The incidence increases with age and is usually associated with obstructive uropathy. Renal abscesses represent 0.2% of all abscesses. intraabdominal, of which 10% of cortical abscesses break through the capsule forming a Perinephritic abscess, which is difficult to manage and leads to a worse prognosis, with high mortality despite prompt surgical treatment.

[Comparison of results of open simple nephrectomy secondary to lithiasis in patients with and without nephrostomy]. / Comparación de los resultados de la nefrectomía simple abierta secundaria a litiasis en pacientes con y sin nefrostomía.

BACKGROUND: Simple nephrectomy is the procedure of choice in the treatment of excluded kidneys. The purpose of this study was to describe and compare surgical results in open simple retroperitoneal nephrectomies in patients with and without nephrostomy. METHODOLOGY: 58 patients were analyzed. The demographic parameters of patients with nephrostomy were compared to patients without nephrostomy (age, gender, weight, lithium localization, transoperative variables (surgical time, transoperative bleeding) and postoperative variables (need for intensive care, need for transfusion, surgical wound infection and hospital stay days) RESULTS: Statistically significant differences were found for the variables of operative bleeding (p=0.0442), surgical time (p=0.0093), hospital stay days (p=0.0040), and transfusion requirements (p=0.0170). There were no differences in the need for intensive care (p=0.6314), transoperative complications (p=0.7414) and surgical wound infection (p=0.2762). CONCLUSIONS: The presence of a nephrostomy catheter in patients undergoing open simple nephrectomy leads to an increased risk of morbidity, with increased bleeding, surgical time, need for transfusion, and hospital stay days.

Treatment of reno-ureteral colic by twelfth intercostal nerve block with lidocaine versus intramuscular diclofenac.

INTRODUCTION AND OBJECTIVE: Renal colic is one of the most intense pains known to humans. Standard treatment usually consists of nonsteroidal anti-inflammatory drugs and opiates, but they do not always provide optimum efficacy and speed in relieving the pain. For more than 25 years, our hospital has been employing twelfth subcostal nerve block. The objective of the present study was to compare the efficacy of subcostal nerve block with lidocaine versus intramuscular diclofenac in renal colic management. METHODS: Sixty patients of both sexes, above the age of 18 years, and presenting with renal colic were randomly selected for the study. The visual analog scale was applied prior to the treatment and at minutes 1, 3, 5, 30, and 45 after the application of the twelfth nerve block or the intramuscular administration of diclofenac. RESULTS: A total of 60 patients, 35 women and 25 men, were included in the study. There were statistically significant differences in the mean scores for pain from minute 1 to minute 45. There were no adverse effects. CONCLUSIONS: Twelfth Subcostal nerve block with lidocaine is an efficacious, safe, inexpensive, and very fast-acting medication for pain control related to renal colic. These characteristics make it superior to diclofenac.