RESUMO
BACKGROUND: This report presents the follow-up data for the incidence of stenosis and reflux in 143 split cuff nipple ureteral intestinal anastomoses in continent urinary diversions. METHODS: 74 ureteral implants (1990-1995) were performed using the original technique, whereas a technical modification was adopted after 1996. This was used in 69 implants and consisted of the removal of a button of bowel tract in order to obtain a linear implant to the reservoir, instead of using a simple enterotomy at the level of the anastomosis. RESULTS: The rate of clinically significant refluxes was 2.2%, whereas the incidence of stenosis fell from 6.8% in the group using the original technique to 2.9% in those using the modified technique. CONCLUSIONS: Anastomosis using the split cuff ureteral nipple technique is simple to perform and is indicated in peristaltic and non-dilatated ureters. Moreover, this technical modification improves the overall results.
Assuntos
Derivação Urinária/métodos , Coletores de Urina , Anastomose Cirúrgica/métodos , Seguimentos , Humanos , Incidência , Complicações Pós-Operatórias/epidemiologia , Estudos RetrospectivosRESUMO
Leydig cell tumors represent about 3% of all testicular neoplasms. Actually no specific pathologic criteria has really distinguished the benign from the malignant tumors which represent about 11% of the cases. The presence of metastases is the only unequivocal criteria of malignancy. Authors present a rare Leydigoma case with gynecomastia. Clinical, diagnostical and most of all therapeutical aspects are discussed reconfirming the role of the orchifuniculectomy in T1 N0 M0 stage.
Assuntos
Tumor de Células de Leydig/cirurgia , Orquiectomia , Neoplasias Testiculares/cirurgia , Adulto , Estradiol/sangue , Ginecomastia/etiologia , Ginecomastia/cirurgia , Humanos , Tumor de Células de Leydig/sangue , Tumor de Células de Leydig/complicações , Masculino , Hormônios Adeno-Hipofisários/sangue , Neoplasias Testiculares/sangue , Neoplasias Testiculares/complicações , Testosterona/análiseRESUMO
The authors present the long-term of adjuvant chemotherapy using M-VEC scheme (Mtx 20 mg/mq; vinblastine 0.1 mg/kg; CDDP 40 mg/mq; epirubicin 30 mg/mq each 21 day for six cycles) effected in 28 patients (21 males and 7 women with average age of 67) undergone radical cystectomy for invasive bladder carcinoma p G2-3 T-4 N + M0. Total survival after 5 years was 28.6% while disease-free survival is 18.8%; in 71.3% there are been clinical progression and the mortality to 5 years was 62%.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Bexiga Urinária/tratamento farmacológico , Idoso , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Epirubicina/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Invasividade Neoplásica , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Vimblastina/administração & dosagemRESUMO
The case of a multiple kidney cyst in an adult patient is described. The cyst had caused parenchymal atrophy by blocking the excretory ways. The pathological anatomy of the lesion is described and the aetiopathogenic hypotheses found in the literature are reported.
Assuntos
Neoplasias Renais/patologia , Doenças Renais Policísticas/patologia , Tumor de Wilms/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
An integrated therapeutic approach was adopted to treat metastatic renal carcinoma, the reason being: 1) to effect a regression of metastasis that could not be attacked surgically either because of its location or extent; 2) to limit micrometastatic diffusion in patients with N+.0.05 mg/kg Vinblastine was used every three weeks in association with alfa-2A-IFN in a dose of 18 X 10(6) U 3 times a week. Included in this study were twelve patients with renal carcinoma subjected to nephrectomy with lymph nodal metastases and with or without remote M+. Without drawing hasty conclusions, this therapy can be said to have a useful role after correct surgical approach.
Assuntos
Carcinoma de Células Renais/secundário , Interferon Tipo I/uso terapêutico , Interferon-alfa/uso terapêutico , Neoplasias Renais/cirurgia , Vimblastina/uso terapêutico , Neoplasias Ósseas/secundário , Neoplasias Ósseas/terapia , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/terapia , Terapia Combinada , Avaliação de Medicamentos , Humanos , Interferon alfa-2 , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/terapia , Metástase Linfática , Nefrectomia , Proteínas Recombinantes , Neoplasias Retroperitoneais/secundário , Neoplasias Retroperitoneais/terapiaRESUMO
The recent introduction of endourology and accumulated experience has led to the development of concepts regarding the effective role of conservative surgical treatment in cancer of the upper urinary tract. The Authors report their experience in 59 patients with cancer of the upper urinary tract; 36 (61.2%) underwent radical surgery whereas 23 (38.9%) were treated using conservative surgical therapy. The results of this retrospective study confirm the role of conservative surgical therapy in cases at an initial stage of cancer development, together with an attentive endourological follow-up.
Assuntos
Neoplasias Renais/cirurgia , Neoplasias Ureterais/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Neoplasias Renais/epidemiologia , Neoplasias Renais/mortalidade , Masculino , Recidiva Local de Neoplasia/epidemiologia , Nefrectomia , Taxa de Sobrevida , Ureter/cirurgia , Neoplasias Ureterais/epidemiologia , Neoplasias Ureterais/mortalidade , Bexiga Urinária/cirurgiaRESUMO
The primary caudal site of the urogenital anlage in the embryo explains why certain positional anomalies occur during cranial migration and are the outcome of various associated factors. A case of ectopic fusion in the ileo-sacral site known as cake kidney whose peculiarity consists of totally asymptomatic right multiple reno-ureteral lithiasis identified by chance is reported.
Assuntos
Cálculos Renais/diagnóstico , Rim/anormalidades , Cálculos Ureterais/diagnóstico , Adulto , Dispepsia/diagnóstico por imagem , Feminino , Humanos , Rim/embriologia , Cálculos Renais/etiologia , Radiografia Abdominal , Cálculos Ureterais/etiologiaRESUMO
Impotentia erigendi is a consequence of radical surgery such as cystectomy due to neoplasia. It is caused by damage to neurovascular structures, and in particular to the nerve fibres of the sacral plexus. Current therapies include the use of penile prostheses or drug therapy. The paper reports the Authors' personal experience of the use of intracavernous drug therapy in 24 patients cystectomised due to vesical carcinoma. Objectively valid results were obtained in 33% of patients. No complications were observed and the treatment represents a valid alternative to mechanical prosthesis.
Assuntos
Cistectomia/efeitos adversos , Disfunção Erétil/tratamento farmacológico , Papaverina/uso terapêutico , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Disfunção Erétil/etiologia , Humanos , Injeções , Plexo Lombossacral/lesões , Masculino , Pessoa de Meia-Idade , Papaverina/administração & dosagem , Pênis , Neoplasias da Bexiga Urinária/complicaçõesRESUMO
The Authors propose a medical treatment for Benign Prostatic Hyperplasia (BPH) using mepartricina-simvastatina, two drugs with a hypocholesterolemizing action. We have treated fifty patients with BPH (twelve with permanent catheters) obtaining a complete clinical results in 40% of the total and a partial clinical result in 38%. This therapy, in association with a correct diet and adequate physical activity, significantly improved not only the cervicurethral obstruction but also general hematochemical and, above all, lipidemic parameters.
Assuntos
Anticolesterolemiantes/uso terapêutico , Lovastatina/análogos & derivados , Mepartricina/uso terapêutico , Hiperplasia Prostática/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Combinada , Humanos , Lovastatina/uso terapêutico , Masculino , Pessoa de Meia-Idade , SinvastatinaRESUMO
The importance of diet within the framework of effective therapeutic measures in the prophylaxis of recurring lithiasis is emphasised. Some diet sheets are presented.
Assuntos
Dietoterapia/métodos , Cálculos Renais/prevenção & controle , Cálcio/metabolismo , Cistina/metabolismo , Humanos , Absorção Intestinal , Oxalatos/metabolismo , Ácido Úrico/metabolismoRESUMO
Authors show results of adjuvant chemoimmunotherapeutic approach (0, 10 mg/kg Vinblastine every three weeks plus INF - alpha 2a - and INF - alpha 2b in a dose of 3 x 10(6) U.I. three times a week) adopted after radical nephrectomy in 45 patients with renal carcinoma (p. T3/4. NO.MO; pT3/4. N+/O. M+/O). The treatment may be summed up: 1# to effect a regression of metastasis that is not possible surgically to remove either because of its location or extent; 2) to limit micrometastatic diffusion in patients with N+. 3) It is important to perform this treatment in stage T3 N0M0 where clinical progression is (21.1%) in our group.