ABSTRACT
Cancer of the testis is uncommon in young males. It can present in unusual ways. We are presenting a case of testicular cancer presenting as an epididymal lesion that was diagnosed after epididymectomy.
Subject(s)
Pain/etiology , Seminoma/complications , Seminoma/surgery , Testicular Neoplasms/complications , Testicular Neoplasms/surgery , Diagnosis, Differential , Diagnostic Imaging , Humans , Male , Middle Aged , Pain Measurement , Seminoma/diagnosis , Testicular Neoplasms/diagnosisSubject(s)
Abdomen, Acute/etiology , Urethra/abnormalities , Abdomen, Acute/surgery , Adult , Humans , Male , Urethra/surgeryABSTRACT
OBJECTIVE: To evaluate the results of the first 72 laparoscopic pelvic lymph node dissections in patients with prostate cancer. DESIGN: Retrospective study of records. SETTING: Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. METHOD: A retrospective study of records provided data on 72 patients with prostate cancer staged by laparoscopic lymph node dissection in the period 1993-1997. Per- and postoperative complications, operation time, number of removed lymph nodes, pathology result and duration of hospital stay were assessed. A comparison was made between the first series of 36 patients and the second series. RESULTS: In 9 patients the laparoscopic approach was converted to a laparotomy. This occurred six times in the first series of 36 patients and three times in the second series. The postoperative course was complicated six times in the first and four times in the second series. With increasing experience the mean operation time decreased from 140 min to 114 min in the second series (p < 0.0001). The mean number of nodes removed was equal in both series (7.5). Lymph node metastases were found in 20 patients (28%). Hospital stay was 2.9 days in the first series and 2.2 days in the second series (not significant). CONCLUSION: Laparoscopic pelvic lymph node dissection is a minimally invasive method for staging patients with prostate cancer. This staging procedure is of great benefit in patients scheduled for treatment with curative intent because of its accuracy and low morbidity. With increasing experience operation time, hospital stay and number of complications decrease.
Subject(s)
Laparoscopy , Lymph Node Excision/methods , Prostatic Neoplasms/pathology , Prostatic Neoplasms/secondary , Aged , Endoscopy/adverse effects , Humans , Laparoscopy/adverse effects , Length of Stay , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Reoperation , Retrospective StudiesABSTRACT
BACKGROUND: For oromandibular reconstructions, an osteocutaneous fibula flap provides sufficient bone and pliable skin. Sensory reinnervation could possibly prevent problems in mastication and deglutition. METHODS: In this anatomic study, 33 cadaver limbs were microsurgical dissected. We investigated the lateral sural cutaneous nerve (LSCN), which supplies sensation to the skin of the lateral lower leg, in relation to the fibula skin flap. The fibula is vascularized by the peroneal vessels via the posterior intermuscular septum. Therefore, the posterior septum determines the center line of the flap design. RESULTS: The LSCN runs in 74% of the dissections posterior to the posterior septum, whereas an anterior branch was seen in 26%. In 54% of the dissections, the distance to the posterior septum was within 3 cm from the septum, whereas in 86%, the distance was found to be within 4 cm. CONCLUSION: The skin flap should be designed more posteriorly to achieve maximal reinnervation.