Laparoscopic intracorporeal ileal ureter replacement: multi-institutional data from 102 patients.

OBJECTIVE: To present long-term results of our laparoscopic intracorporeal ileal ureter replacement (LIUR) cohort, including more complex cases of laparoscopic ileocalycostomy. MATERIAL AND METHODS: We collected records of patients undergoing LIUR. Follow-up included a chemical profile and urine cultures. Imaging consisted of renal ultrasonography, excretory urography, cystography, and computer tomographic or magnetic resonance urography. RESULTS: One hundred and two patients were included. Stricture location was left (46.1%), right (39.2%), or bilateral (14.7%). No open conversion was performed. Seventy-four patients (72.5%) underwent a total ureteral unit removal. The mean operative time was 289.4 (120 - 680) minutes. The estimated blood loss was 185.2 (10-400) mL. Three patients had intraoperative complications, and fifteen had early postoperative complications. The mean postoperative hospital stay was 12.2 (7-35) days. The mean follow-up duration period was 37.7 (12-162) months. Most patients' follow-up was uneventful (88%), and seven patients presented with Grade 2 late complications. CONCLUSIONS: Intracorporeal laparoscopic ileal ureteral replacement in cases of extensive ureteral lesions offers optimal long-term outcomes and a low complication rate. Ileocalycostomy constitutes a viable option in the small group of patients with long proximal ureteral strictures and intrarenal pelvis.

Gynecological Benignities Causing Obstructive Uropathy. Review of the Literature.

BACKGROUND/AIM: Obstructive uropathy is defined the clinical entity that is characterized by changing the structural and functional feature of the urinary system due to interruption of normal urinary runoff. Gynecological benignities could rarely cause obstructive uropathy. Material and Methods: In this study the incidence and the severity of obstructive uropathy caused by gynecological benignities, was investigated. Additionally, we examined the spectrum of the contigent therapeutical procedures, in order to contend with this severe clinical entity, as well as the dangerous for life complication of urosepsis. Results: Gynecological benignities can cause obstructive uropathy. These conditions are rarely faced, composing a challenging problem for physicians. In the spectrum of these conditions are included adnexal masses, leiomyomas, pelvic inflammatory disease and endometriosis. Conclusions: Obstructive uropathy due to gynecological benignities is a very rare, difficult and challenging condition and physicians should always consider the existence of uropathy in such cases.

Pancreatic mucinous cystadenocarcinoma: Epidemiology and outcomes.

BACKGROUND: Pancreatic mucinous cystadenocarcinoma is a rare malignancy. Our aim was to investigate the demographic, pathological characteristics, treatment modalities and survival of patients with mucinous cystadenocarcinoma via the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database analysis. MATERIALS AND METHODS: This was a retrospective study of SEER database's records on patients with mucinous cystadenocarcinoma diagnosed from 1988 to 2012. Primary outcome measures were clinico-pathological characteristics, observed and disease-specific survival. RESULTS: A total of 507 patients were identified. Median age at diagnosis was 67 years and most patients were female (68.4%). The tumors were mainly low grade (82.9%, grade I-II) and frequently localized (42.8%) in the body/tail of the pancreas (45.6%). According to Kaplan-Meier curves observed survival was 111 months (95%CI: 82.5, 139.5) vs 14 months (95% CI: 10.9, 17.1) vs 4 months (95%CI: 2.9, 5.1) for patients with localized, regional and distant disease, respectively. One-year disease-specific survival for patients with localized disease was 90.1%, vs. 56.7% for those with regional and 18.7% with distant tumor spread. CONCLUSIONS: Mucinous cystadenocarcinomas tend to be low grade tumors, localized to the pancreatic body/tail. Surgery as the primary therapeutic intervention and tumor stage are independent predictors of disease-specific survival.