ABSTRACT
PURPOSE: We report our past experience on a sample of patients who underwent pelvic surgery to treat infiltrating bladder tumours. RESULTS: We observed the highest incidence of TVP (33.3%, 3 out of 9) in those patients with higher risk due to anaesthesia and type of surgery. One of our patients died of pulmonary embolism. DISCUSSION: Abdominal pelvic surgery in tumour-bearing patients can be risky due to high incidence of distal and proximal venous thrombosis often resulting in fatal pulmonary embolism (EP). The general risk factors should be evaluated. The diagnosis of venous thrombosis can be difficult to achieve only by clinical examination. Heparin administration as well as surgical techniques and physiotherapy are used as prophylactic measures to reduce the risk of venous thrombosis and to speed up recovery. Nowadays, there is an increasing risk of running into legal problems if appropriate measures to minimise the thromboembolism are not taken.
Subject(s)
Postoperative Complications/prevention & control , Thromboembolism/prevention & control , Urinary Bladder Neoplasms/surgery , Aged , Aged, 80 and over , Humans , Middle Aged , Retrospective StudiesABSTRACT
The typical presentation of endometriosis is pelvic pain. Patients with with endometriosis often have associated fertility disorders even if their relationship with the symptoms and signs of endometriosis is not evident. The first line of treatment for endometriosis must be surgery. In case of infertility the preferred approach is laparoscopic, maybe in association with medical treatment and possibly followed up by a second-look. In cases with relevant pelvic pain and involvement of other organs, laparotomy is necessary, particularly when a deep endometriosis is infiltrating the uterosacral ligaments, the rectovaginal septum and the bladder. Medical treatment of endometriosis is based upon the hormone-dependency of the endometriotic lesions inducing a resting status. Adhesions, endometriomas or fibrous sequelae do not respond to medical treatment. We describe a case of recurrent endometriosis treated with radical surgery for relevant lesions and fibrous adhesions of ureters with consequent bilateral hydronephrosis.
Subject(s)
Endometriosis/complications , Hydronephrosis/etiology , Ureteral Obstruction/etiology , Adult , Combined Modality Therapy , Endometriosis/drug therapy , Endometriosis/pathology , Endometriosis/surgery , Female , Fibrosis , Flank Pain/etiology , Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/therapeutic use , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/pathology , Hydronephrosis/surgery , Laparoscopy , Leiomyomatosis/complications , Leiomyomatosis/surgery , Recurrence , Ureter/pathology , Ureteral Obstruction/diagnostic imaging , Ureteral Obstruction/pathology , Ureteral Obstruction/surgery , Urography , Uterine Neoplasms/complications , Uterine Neoplasms/surgeryABSTRACT
OBJETIVOS: La presentación de trombosis venosa profunda en pacientes tumorales, ya fue observada por Trousseau, el siglo pasado. Las alteraciones de la coagulación que ocurren en pacientes tumorales pueden causar trombosis venosa profunda (TVP), especialmente en pacientes con metástasis. La quimioterapia antitumoral, puede incluso incrementar el riesgo de trombosis. En este trabajo presentamos nuestra experiencia. MÉTODO: Hemos analizado las historias clínicas de pacientes sometidos a cistectomía radical de salvación. RESULTADOS: Hemos encontrado la incidencia muy alta de TVP (33,3 por ciento; 3 de 9), en pacientes con riesgo anestésico alto y necesidad de cirugía urgente. Uno de nuestros pacientes falleció de trombosis pulmonar. CONCLUSIONES: El diagnóstico de TVP y trombosis pulmonar, no siempre es fácil y es necesario hacer todas las pruebas para llegar al diagnóstico (examen clínico, test analíticos, etc...) (AU)
