ABSTRACT
El melanoma polipoide, variante exofítica del melanoma, es una forma agresiva y poco frecuente de presentación. Se comunica un caso en el dorso de una paciente de 76 años, sexo masculino, y se realiza una revisión bibliográfica de los factores pronósticos del melanoma
Subject(s)
Humans , Male , Aged , Melanoma/diagnosis , Melanoma/pathology , Polyps/complications , PrognosisABSTRACT
El melanoma polipoide, variante exofítica del melanoma, es una forma agresiva y poco frecuente de presentación. Se comunica un caso en el dorso de una paciente de 76 años, sexo masculino, y se realiza una revisión bibliográfica de los factores pronósticos del melanoma (AU)
Subject(s)
Humans , Male , Aged , Melanoma/diagnosis , Prognosis , Melanoma/pathology , Polyps/complicationsABSTRACT
We present our experience with a modified technique for constructing a continent ileal reservoir, using the terminal ileum in a pre-peritoneal position. The ureters were implanted using the Le Duc-Camey technique; the Benchekroun valve was used as a continence mechanism. This technique was used in 18 patients and its advantages and complications are discussed.
Subject(s)
Ileum/transplantation , Postoperative Complications , Urinary Reservoirs, Continent/methods , Female , Humans , Length of Stay , Male , Pressure , Urinary Incontinence/surgeryABSTRACT
A continent ileal reservoir has been realized. The reservoir is placed outside the peritoneum, in a pre-peritoneal position, in order to allow its fixation by adhesions to the abdominal wall. Furthermore, a Benchekroun's hydraulic valve, adopted as a continent mechanism, is placed distant from the reservoir, by means of a long anti-peristaltic ileal loop, which further prevents the effects of the reservoir enlargement. The reservoir is made up using 40 cm of detubulized ileum; on the afferent loop (10 cm long) the right ureter is implanted according to the Camey-Le Duc technique, on the efferent loop (25 cm long) the left ureter is implanted according to the same technique. The remaining 15 cm of the ileum are used to realize a Benchekroun's hydraulic valve which is exteriorized by means of a skin stoma, placed on the left abdominal wall. With this technique, 18 patients have been operated; the follow-up period is 3 years for the first cases.
Subject(s)
Ileostomy , Urinary Diversion/methods , Female , Follow-Up Studies , Humans , Peritoneum , Time Factors , Urinary Bladder Neoplasms/surgeryABSTRACT
The authors describe the creation of a continent pre-peritoneal ileal urinary reservoir with Benchekroun's valve. This system, performed on 10 occasions with no postoperative complications and currently perfect results, has the following advantages: decreased risk of distension of the reservoir because of its pre-peritoneal position, protection of Benchekroun's valve due to its distance from the reservoir at the end of the antiperistaltic loop, the great ease of creation of the diversion and the superficial situation facilitating any subsequent surgical revisions.
Subject(s)
Dermatologic Surgical Procedures , Ileum/surgery , Urinary Diversion/methods , Humans , Ileum/transplantation , Peritoneum , Prostheses and Implants , Urinary Diversion/instrumentationABSTRACT
The authors report their experience of long-term (7 years) spinal electrostimulation (SES) in 34 cases of neurogenic bladder (spina bifida: 4 cases; traumatic paraplegia: 3 cases; multiple sclerosis: 23 cases; arachnoiditis: 4 cases). SES, performed via the epidural route, reduced urgent micturition and urge by 90%, urge incontinence by 70% and dysuria by 50%. In the majority of patients, urodynamic evaluation revealed a significant reduction in detrusor hyperactivity and uninhibited contractions, an increase in the electrical activity of the striated sphincter, a significant reduction (80%) in vesico-sphincteric dyssynergy with improvement in flow and an increase by more than 70% in the vesical capacity. After three years, the efficacy tended to slowly decrease and became significantly reduced over 5 years. After 7 years, only 2 of the first 10 cases continued to use SES. SES represents a non-aggressive technique and, at the present time, warrants widespread use due to its safety and simplicity.
