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3.
Prostate Int ; 4(2): 61-4, 2016 06.
Article in English | MEDLINE | ID: mdl-27358846

ABSTRACT

BACKGROUND: Despite significant developments in transurethral surgery for benign prostatic hyperplasia, simple prostatectomy remains an excellent option for patients with severely enlarged glands. The objective is to describe our results of robot-assisted simple prostatectomy (RASP) with a modified urethrovesical anastomosis (UVA). METHODS: From May 2011 to February 2014, RASP with UVA was performed in 34 patients by a single surgeon (O.C.) using the da Vinci S-HD surgical system. The UVA was performed between the bladder neck and urethral margin using the Van Velthoven technique. Demographic, perioperative, and outcome data were recorded. Complications were recorded with the Clavien-Dindo system. RESULTS: The mean (standard deviation) age was 68 years (62-74 years). The median preoperative prostate volume (interquartile range) was 117 cc (99-146 cc). Operative time was 96 minutes (78-126 minutes), estimate blood loss was 200 mL (100-300 mL), and two (5.8%) patients required a blood transfusion. No conversion to open surgery was needed. The median specimen weight on pathological examination was 76 g (58-100 g). The average hospital stay was 2.2 days (1-4 days) and average Foley catheter time was 4.6 days (4-6 days). No intraoperative complications were recorded. There were seven (20.5%) postoperative complications, most of them Clavien less than or equal to Grade II. CONCLUSION: The results of our study show that RASP with UVA is a feasible, secure, and reproducible procedure with low morbidity. Additional series with larger patient cohorts are needed to validate this approach.

4.
J Laparoendosc Adv Surg Tech A ; 25(7): 592-4, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26134069

ABSTRACT

Pelvic exenteration is used in the treatment of several pelvic cancers, including those of the rectum, uterus, and bladder. We report the first case of robotic pelvic exenteration for the treatment of symptomatic prostate cancer involving the rectum and bladder. A six-port transperitoneal robotic approach was used. Bilateral extended lymphadenectomy up to the inferior mesenteric artery was performed. The rectum and bladder were removed en bloc, and a double-barrel anastomosis was then performed with both ureters being connected to the lower opening of the colostomy. Operative time was 249 minutes, and estimated blood loss was 600 mL. No intraoperative or postoperative complications were recorded. Biopsy of the rectum and bladder showed prostatic adenocarcinoma with a Gleason score of 9 (5+4), and 1 of 17 nodes was positive for cancer. Postoperative prostate-specific antigen level was 1.24 ng/mL. The patient is already 19 months after surgery with optimal quality of life. Thus pelvic exenteration is a feasible alternative for highly symptomatic prostate cancer involving adjacent pelvic organs.


Subject(s)
Adenocarcinoma/surgery , Lymph Node Excision , Pelvic Exenteration/methods , Prostatic Neoplasms/surgery , Rectal Neoplasms/surgery , Robotic Surgical Procedures , Urinary Bladder Neoplasms/surgery , Adenocarcinoma/secondary , Aged , Humans , Lymphatic Metastasis , Male , Operative Time , Pelvic Exenteration/adverse effects , Pelvis , Prostatic Neoplasms/pathology , Rectal Neoplasms/secondary , Urinary Bladder Neoplasms/secondary
5.
Arch Esp Urol ; 66(6): 597-601, 2013.
Article in Spanish | MEDLINE | ID: mdl-23985461

ABSTRACT

OBJECTIVE: Collecting Duct Carcinoma or Bellini Carcinoma (CDC) is a rare aggressive histological subtype. We present a case of CDC with retroperitoneal recurrence by another histological subtype of renal tumor and review of the literature. METHODS: A 59-year-old man with no relevant clinical history presented gross hematuria. At the time of diagnosis, a computed tomography ( CT) showed a tumor mass occupying the left renal pelvis. Left Laparoscopic radical nephroureterectomy was performed with endoscopic intramural ipsilateral ureter disinsertion. RESULTS: The pathological diagnosis was CDC with negative surgical margins. A CT scan control was performed 10 months later, showed a left retroperitoneal tumor compatible with a local recurrence. We performed a left subcostal laparotomy with complete resection of the mass. Histological diagnosis was large cell carcinoma with components of granular cells and clear cell. CONCLUSIONS: The CDC is a rare subtype of renal cell carcinoma (RCC) and has an aggressive behavior that is associated with poor prognosis. Surgical resection remains the treatment of choice. We present the first reported case of CDC with retroperitoneal recurrence by another histological subtype of renal tumor.


Subject(s)
Carcinoma, Renal Cell/pathology , Kidney Neoplasms/pathology , Kidney Tubules, Collecting/pathology , Retroperitoneal Neoplasms/pathology , Carcinoma, Large Cell/pathology , Humans , Laparoscopy , Male , Middle Aged , Nephrectomy , Recurrence , Tomography, X-Ray Computed , Urologic Surgical Procedures
6.
Arch Esp Urol ; 66(4): 380-4, 2013 May.
Article in English, Spanish | MEDLINE | ID: mdl-23676544

ABSTRACT

OBJECTIVE: The basaloid carcinoma of the prostate (BC) is a rare malignant neoplasm arising from the basal cells of prostatic ducts and acini. We report a case and review the literature. METHODS: A 76-year-old man presented with symptoms of lower obstructive uropathy, the IPSS score was 29 and prostate specific antigen (PSA)of 0,924 ng /ml. Transurethral resection of prostate (TURP) was performed in September 2008, histopathological diagnosis was BC. In February 2009 laparoscopic radical prostatectomy was performed. RESULTS: Histopathological examination revealed a BC with adenoid cystic growth pattern, perineural infiltration and focal involvement of the left seminal vesicle. Immunohistochemically, the cells were negative for PSA, stained and were strongly positive for specific monoclonal antibodies anti-cytokeratin 34ßE12, p63 and BCL-2. The patient has 23 months of follow-up, with complete continence and no evidence of tumor recurrence. CONCLUSIONS: The BC is an extremely rare subtype of malignant tumors of the prostate, where immunohistochemistry plays a fundamental role in diagnosis.


Subject(s)
Carcinoma, Basal Cell/pathology , Prostatic Neoplasms/pathology , Aged , Biomarkers, Tumor/blood , Carcinoma, Adenoid Cystic/pathology , Carcinoma, Adenoid Cystic/surgery , Carcinoma, Basal Cell/surgery , Humans , Laparoscopy , Male , Prostatectomy , Prostatic Neoplasms/surgery , Transurethral Resection of Prostate
7.
Arch. esp. urol. (Ed. impr.) ; 66(4): 380-384, mayo 2013. ilus, tab
Article in Spanish | IBECS | ID: ibc-112793

ABSTRACT

OBJETIVO: El carcinoma basaloide de la próstata (CB) es una neoplasia maligna poco frecuente derivada de las células basales de los conductos prostáticos y acinos. Presentamos un caso clínico y hacemos una revisión de la literatura. MÉTODOS: Paciente de sexo masculino, de 76 años de edad quien consulta por síntomas de uropatía obstructiva baja con score IPSS de 29 y antígeno prostático (APE) de 0.924 ng/ml. Se practica resección transuretral de próstata (RTUP) en Septiembre de 2008 cuya histopatología concluyó CB. En febrero de 2009 se realiza prostatectomía radical laparoscópica. RESULTADOS: El estudio anatomopatológico revela un CB, con patrón de crecimiento adenoideo quístico, infiltración perineural y extensión extraprostática con compromiso focal de vesícula seminal izquierda y márgenes quirúrgicos negativos. En el estudio inmunohistoquímico las células son negativas para Antígeno prostático específico (APE), siendo fuertemente positivas a anticuerpos monoclonales específicos anti-citoqueratina 34βE12, p63 y BCL-2. El paciente lleva 23 meses de seguimiento, con continencia completa y sin evidencias de recurrencia tumoral. CONCLUSIONES: El CB es un subtipo extremadamente raro de los tumores malignos de la próstata, donde la inmunohistoquímica juega un papel fundamental en su diagnóstico (AU)


OBJECTIVE: The basaloid carcinoma of the prostate (BC) is a rare malignant neoplasm arising from the basal cells of prostatic ducts and acini. We report a case and review the literature. METHODS: A 76-year-old man presented with symptoms of lower obstructive uropathy, the IPSS score was 29 and prostate specific antigen (PSA) of 0,924 ng / ml. Transurethral resection of prostate (TURP) was performed in September 2008, histopathological diagnosis was BC. In February 2009 laparoscopic radical prostatectomy was performed. RESULTS: Histopathological examination revealed a BC with adenoid cystic growth pattern, perineural infiltration and focal involvement of the left seminal vesicle. Immunohistochemically, the cells were negative for PSA, stained and were strongly positive for specific monoclonal antibodies anti-cytokeratin 34βE12, p63 and BCL-2. The patient has 23 months of follow-up, with complete continence and no evidence of tumor recurrence. CONCLUSIONS: The BC is an extremely rare subtype of malignant tumors of the prostate, where immunohistochemistry plays a fundamental role in diagnosis (AU)


Subject(s)
Humans , Male , Aged , Neoplasms, Basal Cell/pathology , Prostatic Neoplasms/surgery , Transurethral Resection of Prostate/methods , Immunohistochemistry/methods
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