RESUMEN
INTRODUCTION: Among patients with type 1 diabetes mellitus and end-stage renal disease, simultaneous pancreas-kidney (SPK) transplantation is associated with increased survival compared with solitary kidney transplants or dialysis. METHODS: A retrospective, descriptive study was performed on 101 consecutive SPK transplantation performed in our center over the last 20 years. We excluded six pancreas alone, eight pancreas after kidney, and four retransplantations. We analyzed demographic characteristics and patient and graft survivals. We also compared patient and pancreatic graft survivals between three periods: 1989 to 1999, 2000 to 2003, and 2004 to 2007. In the first period, bladder drainage was performed in all patients. In the second and third periods, it was replaced by enteric drainage. RESULTS: Overall patient survival was 83.2%. Kidney graft loss occurred in 12 (11.8%) patients and pancreas graft loss in 21 (20.7%) patients. Overall pancreatic graft survival was 79.2% with a 1-year value of 87.1%. By periods, pancreatic graft survival was 75% during the bladder drainage era; 76.9% in the second period; and 85.7% in the third period (P = .88). CONCLUSION: SPK transplantations in diabetic patients with end-stage renal disease were associated with improving pancreas graft survival throughout the study period.
Asunto(s)
Trasplante de Riñón/estadística & datos numéricos , Trasplante de Páncreas/estadística & datos numéricos , Adulto , Nefropatías Diabéticas/cirugía , Drenaje/métodos , Femenino , Supervivencia de Injerto , Humanos , Trasplante de Riñón/mortalidad , Trasplante de Riñón/fisiología , Masculino , Persona de Mediana Edad , Trasplante de Páncreas/mortalidad , Trasplante de Páncreas/fisiología , Terapia de Reemplazo Renal/estadística & datos numéricos , Estudios Retrospectivos , Tasa de Supervivencia , Sobrevivientes , Insuficiencia del Tratamiento , Resultado del TratamientoRESUMEN
Bronchoesophageal fistula secondary to lymphoma is a very rare condition, usually associated with chemo-radiotherapy. We report a case of a patient with a non-Hodgkin's lymphoma (NHL) who, after chemotherapy, developed an oesophago-tracheal fistula. Initially it was treated conservatively but due to the lack of response, a stent was inserted. After nearly one year without success, surgery was considered. Right thoracotomy oesophagectomy and closure of the tracheal defect with an intercostal muscle flap and pericardial patch was performed. This was followed by laparoscopic creation of a gastric tube, which was successfully anastomosed to the cervical oesophagus through a cervicotomy. Unlike oesophageal cancer, NHL can have a good prognosis, so curative treatment of the fistula can be considered. Conservative treatment must always be the first option, leaving stenting or surgery for when the problem persists.
Asunto(s)
Fístula Bronquial/etiología , Fístula Bronquial/cirugía , Linfoma no Hodgkin/complicaciones , Fístula Traqueoesofágica/etiología , Fístula Traqueoesofágica/cirugía , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Linfoma no Hodgkin/tratamiento farmacológico , MasculinoRESUMEN
Bronchoesophageal fistula secondary to lymphoma is a very rare condition, usually associated with chemo-radiotherapy. We report a case of a patient with a non-Hodgkin's lymphoma (NHL) who, after chemotherapy, developed an oesophago-tracheal fistula. Initially it was treated conservatively but due to the lack of response, a stent was inserted. After nearly one year without success, surgery was considered. Right thoracotomy oesophagectomy and closure of the tracheal defect with an intercostal muscle flap and pericardial patch was performed. This was followed by laparoscopic creation of a gastric tube, which was successfully anastomosed to the cervical oesophagus through a cervicotomy. Unlike oesophageal cancer, NHL can have a good prognosis, so curative treatment of the fistula can be considered. Conservative treatment must always be the first option, leaving stenting or surgery for when the problem persists (AU)
No disponible
Asunto(s)
Humanos , Masculino , Anciano , Fístula Bronquial/diagnóstico , Fístula Bronquial/etiología , Fístula Bronquial/cirugía , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/tratamiento farmacológico , Fístula Traqueoesofágica/etiología , Fístula Traqueoesofágica/cirugía , Ensayos Clínicos como Asunto/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Fístula Traqueoesofágica/diagnósticoRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Anciano , Laparotomía/métodos , Paniculitis Peritoneal/cirugía , Tratamiento de Urgencia , Paniculitis Peritoneal/complicacionesRESUMEN
INTRODUCTION: Carney's triad is a rare pathogenic entity which consists of the association in young women of multiple condromatosis in the lung, gastric leiomyosarcoma, and extradrenal paraganglioma; although the presence of three at the same time is not required for its diagnosis. CASE REPORT: We present the case of a 27-year-old woman who was diagnosed of pulmonary multiple hamartomatosis and gastric stromal tumor. DISCUSSION: A review of the literature shows the most important prognosis factors and therapeutic options. Surgery for gastrointestinal stromal tumors and extradrenal paraganglioma seems to be the best treatment up to date.
