ABSTRACT
PURPOSE: This is a retrospective study comparing the clinical data and morbidity of transperitoneal radical nephrectomy (TRN) and simple nephrectomy. MATERIAL AND METHODS: From 1st January, 1989 to 1st January, 1996 a total of 90 simple nephrectomies and from 1st January, 1996 to 1st August, 1999 a number of 85 TRN were performed at the Department of Urology of the Saint Stephen Hospital. The analysis of clinical data included operative time, length of analgesics, postoperative hospital stay and blood loss, as well as morbidity. RESULTS: The mean operative time for TRN was 170 min., being 95 min. for simple nephrectomy. The mean blood loss for TRN was 250 ml, and 400 ml for simple nephrectomy. There were different types of morbidity for TRN and simple nephrectomy. The complications of TRN mean minimal risk and easy correctibility. CONCLUSION: Our results demonstrate an overall clear advantage of TRN when compared to simple nephrectomy.
Subject(s)
Nephrectomy/methods , Aged , Aged, 80 and over , Female , Humans , Intraoperative Complications , Male , Middle Aged , Nephrectomy/adverse effects , Retrospective StudiesABSTRACT
PURPOSE: Orthotopic ileal bladder substitution is a well accepted form of urinary diversion providing high quality of life. However, potential metabolic consequences remain a serious problem. These complications are discussed in the present article. MATERIAL AND METHODS: Authors review the metabolic complications of 45 orthotopic ileal neobladder cases. RESULTS: Insufficient absorption (malabsorption) associated with ileal resection is quite rare, while hyperchloremic metabolic acidosis after ileal neobladder is a rather common phenomenon (55%). CONCLUSION: Authors suggest careful patient selection, correct operative technique and vigilant follow-up for successful treatment of metabolic complications.
Subject(s)
Urinary Diversion/adverse effects , Acidosis/etiology , Aged , Aged, 80 and over , Female , Humans , Ileum/surgery , Malabsorption Syndromes/etiology , Male , Middle AgedABSTRACT
A case of urethral amyloidosis is presented in a 31-year-old male patient. Through this case, authors draw attention to the recommended forms of examination in the event of this illness being suspected, and also discuss problems in differential diagnosis. A reviewed the relevant data in the literature is also provided.
Subject(s)
Amyloidosis , Urethral Diseases , Adult , Amyloidosis/diagnosis , Amyloidosis/pathology , Amyloidosis/surgery , Diagnosis, Differential , Humans , Male , Urethral Diseases/diagnosis , Urethral Diseases/pathology , Urethral Diseases/surgery , Urethral Neoplasms/diagnosisABSTRACT
Two cases of spontaneous pelvic rupture are presented. In Case 1 (female, 49 years) and Case 2 (male, 63 years) the rupture was due to obstruction and tumorous compression of the ureter, respectively. Authors deal with the diagnostic difficulties and the possibility of a cure without open surgery. Conservative therapy (double-J ureteral catheter and pigtail catheter) was successful in both cases. The pertinent literature is briefly reviewed.
Subject(s)
Kidney Diseases/therapy , Catheterization , Female , Humans , Kidney Diseases/diagnostic imaging , Male , Middle Aged , Rupture, Spontaneous , Tomography, X-Ray ComputedABSTRACT
Authors report on their results obtained from orthotopic ileal neobladders following 25 cases of radical cystectomy. Analysis is given of the possible complications, their prevention, as well as of surgical techniques. It is determined that orthotopic ileal neobladder is one of the best bladder substitution methods, giving the patient a chance for a high quality of life.
Subject(s)
Urinary Bladder Neoplasms/surgery , Urinary Reservoirs, Continent , Aged , Aged, 80 and over , Cystectomy , Humans , Ileum/transplantation , Middle Aged , Postoperative Complications , Pressure , Quality of Life , Urinary Reservoirs, Continent/adverse effects , Urination Disorders/etiologyABSTRACT
Authors review their early experiences and the oncopathological relations in respect to 25 cases of radical cystectomy involving orthotopic bladder substitution. The difficulties of diagnostics and indication are discussed. Attention is drawn to the fact that pathological "staging", "grading" are not entirely exact and reliable, though surgical indication is positioned on these. It is the opinion of authors that in case of TIG3 radical surgery is indicated. Due to the shortness of the follow-up periods, no studies on survival were performed. It remains an open question whether radical cystectomy is indicated as opposed to the possible choice of organ-preserving surgery.
Subject(s)
Cystectomy , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/surgery , Urinary Reservoirs, Continent , Aged , Aged, 80 and over , Humans , Ileum/transplantation , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Urinary Reservoirs, Continent/adverse effectsABSTRACT
In connection with a report of a case, authors discuss in outline the possibilities of ureter replacement. If both the ureters are injured, they can be substituted with one single segment of the intestine, as it happened in their case. Authors raise the idea that a longer segment of the intestine used for substitution provides sufficient capacity and isoperistaltic function, and this may protect from the negative effects of possible vesicoileal reflux. In this case, the reflux does not spread to the kidneys even if the ureteroileal was not made with anti-reflux technique.
Subject(s)
Ileum/transplantation , Ureteral Diseases/surgery , Anastomosis, Surgical/methods , Carcinoma/drug therapy , Carcinoma/surgery , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Female , Humans , Middle Aged , Nephrostomy, Percutaneous , Pyelonephritis/etiology , Pyelonephritis/surgery , Recurrence , Ureteral Diseases/etiology , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/surgeryABSTRACT
A modified approach is recommended for removal of local relapse following leftside nephrectomy. In the course of transperitoneal mesocolic approach, the retroperitoneum is opened as usual at Treitz's ligament, between the aorta and the inferior mesenteric vein. For further exposure, two or three radial vessels are preserved. Thus, sufficient room ir available between these bridges to remove the tumour, expose the v. cava and the aorta and remove the renal vessels. Mobilization of the colon is not necessary.
