ABSTRACT
Objetivo: Proponemos una modificación de la nefroureterectomía abierta. Método: Mediante una sola incisión (lumbotomía) se efectua una ligadura-sección percutánea del uréter terminal finamente disecado. Resultados/Conclusiones: Ofrece una mejor calidad de vida en el postoperatorio inmediato, acorta el tiempo quirúrgico, y esta lumbotomía tiene la ventaja de ser oncológicamente segura, evitando una doble cirugía (AU)
Objectives: We propose a modification to open nephroureterectomy. Methods: By a single incision (lumbar incision) a percutaneous ligation-section of the finely dissected terminal ureter is performed. Results/Conclusions: This technique offers a better quality of life in the immediate postoperative period, shortens the surgical time, and it has the advantage of being oncologically safe, avoiding a double surgery (AU)
Subject(s)
Humans , Ureteral Neoplasms/diagnosis , Ureteral Neoplasms/surgery , Ligation/methods , Nephrectomy/methods , Ureter/pathology , Ureter/surgery , Ureter , Quality of Life , Retroperitoneal Neoplasms/surgery , Retroperitoneal Space/surgeryABSTRACT
Fifty one cases of tumors detected along a 20 years period (1969 throughout 1989) in newborn infants are described. Most frequent kinds of neonatal tumors were teratomas (n: 30), followed by vascular tumors (n: 6), neuroblastomas IV-S (n: 5), hepatic hamartomas (n: 5), renal tumors (n: 3), soft tissue sarcomas (n: 2) and melanocytic melanoma (n: 1). Follow up was extended from 1 to 20 years. Death occurred in two patients of this series: one in a case of sacrococcygeal teratoma, who died of septicemia secondary to urinary tract obstruction and infection before any attempt of surgical treatment was possible, and by multiple pulmonary metastases one year after apparently satisfactory surgical treatment in another patient with neuroblastoma.
Subject(s)
Neoplasms/epidemiology , Chile/epidemiology , Female , Follow-Up Studies , Hamartoma/epidemiology , Hemangioma/epidemiology , Humans , Infant, Newborn , Male , Neoplasms/therapy , Neuroblastoma/epidemiology , Sarcoma/epidemiology , Teratoma/epidemiologyABSTRACT
Studies were made on the appearance of second malignant tumors (SMT) in children followed in a pediatric hospital at metropolitan Santiago, Chile, between years 1968 and 1987. A retrospective analysis identified SMT in 7 of 430 patients who survived a childhood cancer (incidence 1.62%). An 8th patient was added, whose first neoplasm was treated in another hospital. The initial diagnosis in the affected children were medulloblastoma, neuroblastoma, Wilm's tumor retinoblastoma, Ewing's sarcoma, Hodgkin's disease and, in two cases, acute lymphocytic leukemias. The age range was 6 months to 11 years. Treatment was done by surgery in 5/8, chemotherapy in 7/8 and radiotherapy in all patients. The latent period between the diagnosis of the first cancer and the diagnosis of the SMT was 3.5 to 12 years (median 8.5 years). Osteosarcomas were the most frequent SMT (5/8). The other SMT were a rhabdomyosarcoma, a non Hodgkin lymphoma and an astrocytoma. The majority of SMT were located in the area of prior radiotherapy (6/8). In the other two cases, one had an osteosarcoma, after a bilateral retinoblastoma, which grew outside the previously treated area, and the last one consisted of a lymphoma which was identified 9 years after an acute lymphocytic leukemia. Only 3/8 SMT patients are alive after 14.21 and 34 months follow up. The other children died between 11 and 20 months after diagnosis of SMT. Notwithstanding these kinds of outcome, benefits of therapy for patients with primary tumors greatly outweight the later risk of cancer induction in a small proportion of them.
Subject(s)
Neoplasms, Second Primary/epidemiology , Child , Child, Preschool , Chile/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Infant , Male , Retrospective StudiesSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Lymphoid/drug therapy , Actuarial Analysis , Adolescent , Child , Child, Preschool , Doxorubicin/administration & dosage , Female , Humans , Infant , Leukemia, Lymphoid/mortality , Male , Mercaptopurine/administration & dosage , Methotrexate/administration & dosage , Prednisone/administration & dosage , Vincristine/administration & dosageSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasms, Germ Cell and Embryonal/therapy , Orchiectomy , Testicular Neoplasms/therapy , Adolescent , Bleomycin/administration & dosage , Child , Child, Preschool , Cisplatin/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Dactinomycin/administration & dosage , Humans , Infant , Male , Methotrexate/administration & dosage , Prognosis , Teratoma/diagnosis , Testicular Neoplasms/mortality , Vinblastine/administration & dosage , alpha-Fetoproteins/analysisSubject(s)
Neoplasms, Germ Cell and Embryonal/pathology , Ovarian Neoplasms/pathology , Adolescent , Child , Child, Preschool , Dysgerminoma/pathology , Female , Humans , Infant , Mesonephroma/pathology , Neoplasm Staging , Neoplasms, Germ Cell and Embryonal/mortality , Ovarian Neoplasms/mortality , Teratoma/pathologySubject(s)
Immunosuppressive Agents/adverse effects , Toxoplasmosis/etiology , Adolescent , Child , Child, Preschool , Female , Fluorescent Antibody Technique , Humans , Immunosuppressive Agents/therapeutic use , Infant , Leukemia/drug therapy , Lymphoma/drug therapy , Male , Toxoplasmosis/diagnosisABSTRACT
Between 1968 and 1979 we treated 19 patients with infantile embryonal carcinoma of the testis. All 10 patients treated with orchiectomy plus chemotherapy (methotrexate, actinomycin D and cyclophosphamide) are well with no evidence of disease, whereas 2 of 4 who underwent orchiectomy alone and 2 of 5 treated with orchiectomy plus lymphadenectomy are dead. Infantile tumors with yolk sac elements have an apparent increase in hematogenous spread and, despite negative lymph nodes in the majority, a significant number have subsequent disseminated metastases. This suggests that infantile embryonal carcinoma is different from the adult type and implies that in clinical stage A disease retroperitoneal lymphadenectomy is unnecessary. The alpha-fetoprotein correlates with the presence of yolk sac tissue in biopsy and the radioimmunoassay level assists in monitoring the treatment.
