ABSTRACT
Locally advanced bladder cancer causes unpleasant symptoms such as irritative voiding symptoms, lower abdominal pain, gross hematuria and urinary retention, and lowers the quality of life. Treatment decisions in elderly patients may be difficult, as elderly patients are physically and psychologically different from younger patients. An 89-year-old male was referred to hospital for the treatment of an invasive bladder tumor with right hydronephrosis from tumor obstruction. The patient was elderly and did not have a good performance status; therefore curative radical cystectomy or chemotherapy was not indicated. Left retroperitoneoscopic ureterocutaneostomy was performed to alleviate gross hematuria and voiding difficulty. Intensity-modulated radiotherapy was administered 9 days after the surgery to control bleeding in the bladder tumor. After completing 8 days of radiotherapy, the patient was discharged from hospital. The patient exhibited no signs of either postrenal failure or gross hematuria for 7 months prior to mortality. Retroperitoneoscopic ureterocutaneostomy for very elderly patients with advanced bladder cancer with a poor performance status may be an important procedure for alleviating symptoms and improving quality of life.
ABSTRACT
A 56-year-old woman underwent laparoscopic right nephrectomy due to pyonephrosis associated with right ureteral stones. Moreover, the patient developed a brain stem hemorrhage and became bedridden. At the time of nephrectomy, a renal tumor, with a size of 24 × 24 × 20 mm, was observed in the left renal hilum; the tumor did not show contrast enhancement on computed tomography. After 3 years, the tumor gradually grew to a size of 45 × 35 × 34 mm, and therefore, laparoscopic non-clamping tumor enucleation was performed. Pathological examination confirmed a diagnosis of renal schwannoma.
ABSTRACT
Vascular abnormalities in neurofibromatosis type 1 (NF-1) are rare but sometimes fatal. We report a case of spontaneous rupture of a left renal artery aneurysm in a patient with NF-1. A 41-year-old nonpregnant normotensive woman known to have NF-1 presented to our emergency department with left flank pain. Computed tomography showed a large retroperitoneal hematoma due to left renal artery aneurysm rupture. She was treated with selective transcatheter coil embolization and fully recovered.
Subject(s)
Aneurysm, Ruptured/etiology , Neurofibromatosis 1/complications , Renal Artery , Adult , Aneurysm, Ruptured/diagnosis , Aneurysm, Ruptured/therapy , Embolization, Therapeutic , Female , Flank Pain/etiology , Hematoma/etiology , Humans , Neurofibromatosis 1/diagnosis , Renal Artery/diagnostic imaging , Risk Factors , Rupture, Spontaneous , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 18-year-old man presented with fever and periumbilical nodule. Computed tomography (CT) showed complicated abscess of urachal remnant and laparoscopic surgery was performed transperitoneally via 3 ports. Laparoscopic excision of urachal remnant was first demonstrated in 1992 by Neufung et al, and in Japan first case was reported in 1998 by Ohmori et al. Some cases of laparoscopic surgery for urachal remnant were reported, but the surgical techniques, including port configuration, have not been standardized. In this case, we performed laparoscopic surgery with camera port in the umbilicus and two working ports in the bilateral positions. Our port configuration may be promising in ensuring good viewing during surgery and excising urachal remnant completely including umbilicus.
