[Videothoracoscopy, laparoscopy and minimal-access surgery]. / Videotoracoscopia, laparoscopia y cirugía de mínimo acceso.

Since we start our way in endoscopic surgery, a total of 101 procedures (93 by laparoscopy and 8 by thoracoscopy) have been performed. In two cases (splenectomy, lobectomy) the combination with a minimal enlargement of the wall incision let us remove the entire piece and reduce the operatory time. This is the review of our experience. While the 51.5% of the cases concern to the genitourinary system, the 40.5% of the pathology was digestive and only the 8% was thoracic. The age of the patients ranged between 20 days and 17 years with a clear predominance of the boys. Absence of complications and a high grade of success should do laparoscopy and thoracoscopy frequent surgical procedures in any department of pediatric surgery.

[Ureterocele. Tailored treatment. Report of 45 cases]. / Ureterocele. Tratamiento individualizado. A propósito de 45 casos.

The advancements in the treatment of ureterocele have prompted early diagnosis of this condition. We report on 45 cases of ureterocele (6 simple and 39 ectopic) that had been treated at our service from 1974 to 1992. The present series comprised 43 patients (32 females, 13 males), with ages ranging from 20 hours to 9 1/2 years; three cases had been diagnosed prenatally. All cases were evaluated by IVP and cystography. There were 16 cases of left ureteropelvic duplicity, 11 right and 10 bilateral. There was one case with right triplication and 6 cases with single system. Fourteen cases had reflux in the lower ipsilateral kidney, 5 in the contralateral kidney and 4 were bilateral. In some cases, patient evaluation included the use of isotopes, US, CT and cystography. Two cases required no surgical procedure; 2 required endoscopic incision; 6 resection and reimplantation; 1 heminephrectomy; 19 resection and heminephrectomy; 1 resection, reimplantation and ureteropyelostomy; 8 resection and nephrectomy; aspiration, nephrectomy and resection of the ureterocele was required in 1 case. Control evaluation at 6 and 18 months following treatment was satisfactory in 88.3%; of these, 41.8% had pyelonephritic scars, 16.2% had residual reflux and 4.6% urinary incontinence. There was only one death.