ABSTRACT
Objetivo: El objetivo principal de este estudio es evaluar la concordancia del reporte de la clasificación Vesical Imaging-Reporting and Data System (VI-RADS®) en resonancia magnética (RM) y el reporte de patología del espécimen de cistectomía y definir si este estudio puede considerarse un estándar en el proceso de estadificación en el paciente con diagnóstico clínico de cáncer de vejiga. Método: Estudio analítico retrospectivo de corte transversal, se incluyeron 34 pacientes llevados a cistectomía radical o parcial a quienes se realizó RM multiparamétrica prequirúrgica y se realizó un estudio de concordancia entre la clasificación VI-RADS® y el resultado de patología. Todas las resonancias fueron leídas y revisadas por un único radiólogo institucional. Resultados: El estudio de concordancia como resultado principal mostró un área bajo la curva para VI-RADS® ≥ 4 y resultado patológico positivo para compromiso muscular de 0,84, con una sensibilidad del 89.3% y especificidad del 50%, demostrando la adecuada precisión diagnóstica de la prueba. Conclusiones: La clasificación VI-RADS® es una herramienta de diagnóstico caracterizada por un excelente rendimiento diagnóstico cuando se evalúa la concordancia con el reporte de la patología final en el espécimen de la cistectomía.
Objective: The main objective of this study is to assess the concordance of the magnetic resonance imaging (MRI) Vesical Imaging-Reporting and Data System (VI-RADS®) classification report and the pathology report of the cystectomy specimen and to define whether this study can be considered a standard in the staging process in patients with a diagnosis of bladder cancer. Method: Retrospective, cross-sectional analytical study that included 34 patients undergoing radical or partial cystectomy who underwent pre-surgical multiparametric MRI. A concordance study was performed between the VI-RADS® classification and the pathology result. All MRIs were read and reviewed by a single institutional radiologist. Results: The concordance study as the main result showed an area under the curve for VI-RADS® ≥ 4 and a positive pathological result for muscle involvement of 0.84, with a sensitivity of 89.3% and a specificity of 50%, demonstrating the adequate diagnostic accuracy of the test. Conclusions: The VI-RADS® classification is a diagnostic tool characterized by excellent diagnostic performance when evaluating the agreement with the final pathology report in the cystectomy specimen.
Subject(s)
Humans , Middle Aged , AgedABSTRACT
Testicular germ cell tumors, including seminomas, originate mainly from the testicles and rarely from extragonadal locations, often retroperitoneum and mediastinum. Moreover, primary seminal vesicle tumors are extremely rare, and the most described histology is adenocarcinoma. We report, as far as we know, the second case of primary seminoma of the seminal vesicle.
ABSTRACT
Objetivo La Urolitiasis constituye un motivo de consulta común, con una alta incidencia y prevalencia. Cuando los cálculos renales son mayores a 20 mm, la primera línea de tratamiento es la nefrolitotomía percutánea. En Colombia existe poca información sobre la evaluación de las características de los pacientes y las complicaciones asociadas a ese procedimiento quirúrgico. Este estudio, busca determinar la prevalencia de las complicaciones en nefrolitotomía percutánea en una clínica de Medellín entre los años 2015 y 2017. Métodos Estudio observacional retrospectivo en el que se analiza la prevalencia de complicaciones mayores que presentaron los pacientes sometidos a nefrolitotomía percutánea en una clínica de tercer nivel en la ciudad de Medellín entre los años 2015 y 2017. Resultados a 176 pacientes se les realizó Nefrolitotomía percutánea entre el 2015 y el 2017. Se encontró una prevalencia de complicaciones mayores de 11,4%. El 60,2% de los pacientes que presentaron complicaciones fueron mujeres y la edad media fue de 45,1 años (DE ± 12,5 años). El 60% de los cálculos eran coraliformes. El 45% ubicados en el caliz inferior; siendo bilaterales en el 40% de ellos. La complicación más frecuente, fueron los cálculos residuales en el 6,8% seguido de complicaciones pulmonares en el 6,3% e infecciosas en el 6,3%. Conclusiones La nefrolitotomía percutánea representa un procedimiento quirúrgico relativamente seguro para el abordaje de pacientes con alta carga litiásica con un porcentaje de complicaciones relativamente bajo.
Objective Urolithiasis is a common reason to consult in medical practice. When stones are greater than 20 mm, the first line of treatment is percutaneous nephrolithotomy. This study aims to determine the prevalence of complications in percutaneous nephrolithotomy in a clinic in Medellín Colombia between 2015 and 2017. Methods We present a retrospective observational study in which the prevalence of major complications in patients undergoing percutaneous nephrolithotomy was analyzed in a third level clinic in the city of Medellin - Colombia between 2015 and 2017. Results 176 patients underwent percutaneous nephrolithotomy between 2015 and 2017. A prevalence of complications greater than 11.4% was found. 60.2% of the patients who presented complications were women and the average age was 45.1 years (SD ± 12.5 years). 60% of the stones were staghorn. 45% located in the lower calyx; being bilateral in 40% of cases. The most frequent complication was residual stones in 6.8% followed by pulmonary complications in 6.3% and infectious in 6.3%. Conclusions Percutaneous nephrolithotomy represents a relatively safe surgical procedure for the management of patients with a high lithiasic load with a relatively low percentage of complications.
Subject(s)
Humans , Female , Surgical Procedures, Operative , Prevalence , Nephrolithotomy, Percutaneous , Therapeutics , Kidney Calculi , Colombia , UrolithiasisABSTRACT
BACKGROUND: Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB. METHODS: We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure. RESULTS: A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96). CONCLUSIONS: There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.
