ABSTRACT
@#Wilms tumor is very rare in adults. Even more infrequent is an adult Wilms tumor with an extensioninto the central nervous system.Reported here is a case of an adult Wilms tumor in a 38-year-old female. She was referred to theJRRMMC with a 2 month history of intermittent hematuria associated with a rapidly enlargingabdominal mass and right-sided facial asymmetry. Abdominal computed tomography revealed a largemass inthe rightkidney. CranialMRI showedmultiple brainmetastases. Thepatient underwentrightradicalnephrectomy.Pathologicalanalysisdemonstratednephroblastoma.Thepatientwasdischargedunremarkable and underwent adjuvant chemotherapy. After 2 months, the patient succumbed to thedisease.Adult Wilms tumor presents almost similarly with renal cell carcinoma and there is no definitivediagnostictesttoconfirmitpre-operatively.Eventhoughit’sararetumor,itshouldalwaysbeincludedin the differential diagnosis for any renal tumor.
ABSTRACT
OBJECTIVE@#Specimen retrieval bags were used to remove cysts and masses in minimally invasiveurologic surgeries for more than 3 decades. This study aims to describe the steps in making a home-made specimen retrieval bag named JuRoLap and its safety and resiliency.@*MATERIALS AND METHODS@#The bag’s name was taken from the initials of the institution combined withthe department's short-name (uro) and laparoscopy (Lap). The bag is composed of a non-toxicpolyvinyl chloride (PVC) urine bag custom fitted according to the expected specimen size. The sideswere sealed using an impulse sealer leaving one side open. The bag ways rolled and introducedintracorporeally via the 12mm port. It was opened followed by specimen placement using standardlaparoscopic instruments. Purse-string suture at the one-side opening was tightened and extractedthrough the umbilical port extending the incision as necessary.@*RESULTS@#JuRoLap was used in 33 cases removing various organs such as adrenals, kidney, ureter,bladder and prostate. It was easily prepared, safe, resilient and economical costing approximatelyUSD 0.68. It was essential to routinely check its durability by doing a leak test prior to sterilization.Proper rolling, transparent plastic component of the bag and the use of two laparoscopic graspersprovided ease in bag deployment and specimen entrapment. It was also observed that smaller incisionon extraction site as compared to the specimen size was needed due to the resiliency of the bag.Despite the required learning curve in organ entrapment and extraction, there were no complicationsand specimen leakage noted.@*CONCLUSION@#JuRoLap specimen retrieval bag is organ size specific, safe, resilient and low cost specimenretrieval bag innovation.
Subject(s)
LaparoscopyABSTRACT
Fourniers gangrene is a fulminant, rapidly spreading infection of the scrotum that also involves the perineum, penis, and abdominal wall. Early report have noted that inspite of early consultations, many patients eventually succumb to sepsis. The mortality and morbidity rates in our series were lower as compared to other series and we attribute this favorable outcome to progressive initial care. Early recognition, early hemodynamic stabilization, antibiotic coverage for aerobes and anaerobes, and adequate surgical debridement followed by equally aggressive post-operative care were noted to alter the course of these patients.
Subject(s)
Fournier GangreneABSTRACT
In the Philippines, there is no published data on standard normal values of sperm analysis among fertile Filipino males. This study aims to show the semen parameters of healthy fertile Filipino males aged 20-40 years. Convenience sampling was used. One hundred twenty volunteers were recruited and the semen samples were analyzed for sperm density, motility and morphology. Sperm density ranged from 17.1 to 201.6 million/ml (median 63.3 million/ml). Normal tail morphology range was 55 to 99% (median 85%). Normal tail morphology ranged from 55 to 99% (median 71.5%). These correlate with the standard set by the World Health Organization and is consistent with studies done abroad.