Dioctophyma renale em 28 cães: aspectos clinicopatológicos e ultrassonográficos / Dioctophyma renale in 28 dogs: clinicpathological and ultrasonographic findings

A infecção em cães por Dioctophyma renale, relatada em diversas partes do mundo, é considerada incomum, na maioria das vezes. No entanto, em algumas regiões são descritos números crescentes da infecção e muitos dados da epidemiologia e do ciclo biológico do parasito ainda são obscuros. Dessa forma, o trabalho tem como objetivo descrever os aspectos epidemiológicos, clinicopatológicos e ultrassonográficos de casos de infecção por Dioctophyma renale em cães na região da Fronteira Oeste do Rio Grande do Sul. Foram estudados 28 casos de dioctofimose em cães necropsiados ou clinicamente avaliados, submetidos à ultrassonografia e cirurgia para retirada dos parasitos. Os cães errantes foram os mais acometidos e todos com possível acesso às margens do Rio Uruguai. As lesões renais e extrarrenais foram caracterizadas predominantemente por atrofia do parênquima renal com glomerulonefrite esclerosante e peritonite granulomatosa associada a parasitos adultos livres na cavidade abdominal e ovos, bem como migrações erráticas para o tecido subcutâneo. Por fim, os achados ultrassonográficos corresponderam, especialmente, a imagens transversais circulares de até 0,6 cm de diâmetro, com margem hiperecoica e centro hipoecoico. Esses achados foram patognomônicos para infecção por Dioctophyma renale, e o exame ultrassonográfico se mostrou indispensável para o diagnóstico definitivo durante a avaliação clínica. Os achados observados nesse estudo demonstram a importância dessa parasitose na região. Além disso, alertam para a importância do diagnóstico, que vem sendo subestimado, além de apontar a necessidade de mais dados acerca da epidemiologia da doença para que se chegue a métodos efetivos de controle...

Dioctophyma renale infection in dogs is being considered uncommon for most parts of the world. However, some regions show an increase of this infection; but many data of the epidemiology and the biological cycle of the parasite are still unclear. The present study describes the epidemiological, clinicpathological and ultrasonographic aspects of 28 cases of infection by Dioctophyma renale in dogs in the West Frontier region of Rio Grande do Sul, Brazil. Street dogs were the most affected and all of them had access to the banks of the Uruguay River. The renal and extra-renal lesions were predominantly characterized by atrophy of the renal parenchyma, sclerotic glomerulonephritis and granulomatous peritonitis, associated with free adult parasites and eggs in the abdominal cavity and erratic migration into the subcutaneous tissue. The ultrasound findings corresponded especially to the circular cross-sectional images with 0.6cm in diameter at most, with hyperechoic margin and hypoechoic center too. These findings were pathognomonic for Dioctophyma renale infection and this examination was essential for the definitive diagnosis by clinical evaluation. The results of the study demonstrate the importance of this parasitism in the region, alert that the diagnosis has being underestimated, and point out the need to clarify its epidemiology in order to reach effective control measures...

Clinical application of transperitoneal laparoendoscopic single-site nephrectomy / 中华泌尿外科杂志

Objective　To verify the safety and feasibility of applying transperitoneal laparoendoscopic single-site surgery (LESS) nephrectomy in the treatment of kidney malignant and benign diseases.Methods　From Nov.2010 to Jun.2012,we had used LESS nephrectomy technique treated four kidney tumors,one renal pelvic tumor and one atrophic kidney. Quadport was introduced into abdominal cavity through a paraumbilical incision. Conventional laparoscopic instruments,prebent laparoscopic instruments and flexible tip 5mm laparoscope were used. The standard laparoscopic transperitoneal nephrectomy technique was then performed.We evaluated this technique in respects of operative time,estimated blood loss,intraoperative complications,1st post-operative day pain (VAPS),drainage time,post-operative hospital stay and pathological results.　Results　The 6 procedures in this group were completed successfully with LESS nephrectomy. There was no additional trocar added,no conversion to conventional laparoscopic or open surgery.Application of Quadport and prebent instruments reduced the clash of instruments,both intracorporally and extracorporally.The average operative time were 181.7 (145.0 -235.0) min,average estimated blood loss were 78.3 (20.0 - 150.0) ml.There was no severe intraoperative complication.The average VAPS in the first post - operative day was 1.7 ( 1.0 - 2.0).The average drainage time was 2.8 ( 1.0 -4.0) d,post-operative hospital stays was 6.8 ( 1.0 - 10.0) d.There was no secondary bleeding or wound infection.Pathological results showed 3 cases of renal clear cell carcinoma,1 case of chromophobic carcinoma,1 case of high-grade urothelial carcinoma and 1 case of atrophic kidney.All the specimens in this group were surgical margin negative.　Conclusions　LESS nephrectomy is a safe and feasible treatment option for the treatment of kidney surgical diseases.