ABSTRACT
PURPOSE: To report a single center experience with elective surgical patients as living kidney donors. METHODS: We retrospectively analyzed a prospective database of 458 living kidney donors from September 2005 to May 2011. Fifteen (3.2%) of them were elective surgical patients simultaneously undergoing living donor nephrectomy. We reviewed age, gender, operative time, intraoperative blood transfusion, intra- and postoperative complications, as well as length of hospital stay. Recipients were evaluated for delayed graft function. Four hundred forty-three patients undergoing living donor nephrectomy alone composed the control group. RESULTS: Among the elective surgical patients group, the mean (range) operative time was 155 (90 to 310) minutes and mean (range) length of hospital stay was 3 (2 to 9) days. One (6.7%) recipient displayed delayed graft function. Among the regular living kidney donors group, the mean (range) operative time was 100 (70 to 150) minutes, mean (range) length of hospital stay was 3 (2 to 5) days, and delayed graft function was observed in 5.6% of recipients. Only operative time (P = .03) was significantly different between the groups. CONCLUSIONS: Elective surgical patients are potential donors who may be treated at the same time as the living donor nephrectomy.
Subject(s)
Adrenalectomy , Cholecystectomy , Herniorrhaphy , Kidney Transplantation/methods , Living Donors , Nephrectomy , Tissue and Organ Harvesting/methods , Adrenalectomy/adverse effects , Adult , Aged , Brazil , Chi-Square Distribution , Cholecystectomy/adverse effects , Delayed Graft Function/etiology , Elective Surgical Procedures , Female , Herniorrhaphy/adverse effects , Humans , Kidney Transplantation/adverse effects , Longevity , Male , Middle Aged , Nephrectomy/adverse effects , Retrospective Studies , Risk Factors , Time Factors , Tissue and Organ Harvesting/adverse effects , Treatment OutcomeABSTRACT
CONTEXT: Extension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease. DESIGN: Case report. CASE REPORT: We report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens.
Subject(s)
Adrenal Gland Neoplasms/pathology , Pheochromocytoma/pathology , Vena Cava, Inferior/pathology , Adrenal Gland Neoplasms/diagnostic imaging , Adrenal Gland Neoplasms/surgery , Adult , Humans , Male , Neoplasm Invasiveness , Pheochromocytoma/diagnostic imaging , Pheochromocytoma/surgery , Radiography , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/pathology , Retroperitoneal Neoplasms/surgery , Vena Cava, Inferior/surgeryABSTRACT
UNLABELLED: The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyps distributed along the small intestine. Enterotomy was performed to treat only the larger polyps, therefore limiting the intestinal resection to smaller segments. The postoperative follow-up was uneventful. CONCLUSION: We point out the importance of conservative treatment for patients with this syndrome, especially those who will undergo repeated surgical interventions because of clinical manifestation while they are still young.
