RESUMEN
We present a case of a lonely bone lesion after a prostatic adenocarcinoma with recurrent increased PSA. The localization of the metastasis at the level of a rib is infrequent. The precise localization of the lesion was made possible by intraoperative scintigraphy. Histology confirmed the complete resection of the lesion with safe margins.
Asunto(s)
Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/secundario , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias de la Próstata , Costillas , Adenocarcinoma/cirugía , Neoplasias Óseas/cirugía , Humanos , Cuidados Intraoperatorios , Masculino , Persona de Mediana Edad , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/cirugía , Cintigrafía , Radiofármacos , Costillas/cirugía , Medronato de Tecnecio Tc 99mRESUMEN
OBJECTIVE: To evaluate the results of one-stage bilateral rigid ureteroscopy for the treatment of bilateral ureteric stones and to identify predictive factors of failure. MATERIALS AND METHODS: From January 1995 to June 2006, 61 patients were hospitalised for bilateral ureteric stones. Fifty patients, that is, 100 renal units were treated by first-line one-stage bilateral rigid ureteroscopy using an 8 F rigid ureteroscope and a ballistic lithotriptor. A complete statistical analysis (bivariate analysis completed by multivariate analysis) was performed to identify predictive factors of intraoperative failure. RESULTS: The overall success rate per patient (success on at least one side) was 92% (with bilateral success in 70% of cases). Statistical analysis revealed a statistically significant difference between the two failure/success groups for mean stone diameter (p < 0.1%), site (p = 0.6%) and degree of cavity dilatation (p = 4%). Similarly, a strong statistical correlation was observed between these variables and intraoperative failure. The intraoperative complication rate was 4% (two patients) and the postoperative complication rate was 16%, corresponding to minor complications in every case (low back pain, fever) not requiring a supplementary procedure. CONCLUSION: One-stage bilateral rigid ureteroscopy achieved satisfactory results similar to those of unilateral ureteroscopy. Predictive factors of failure were: stone diameter (greater than 15 mm), stones in the lumbar ureter and marked cavity dilatation.