RESUMEN
BACKGROUND: Pelvic soft tissue sarcomas are rare. Potentially curative resection remains challenging due to anatomical constraints of true pelvis and tumour spread through various anatomical hiatus. We sought to review the oncological outcomes of surgically managed cases at our centre and determine whether outcomes differ for patients with localised (limited to pelvis) versus extensive disease (with extra-pelvic extension). METHODS: Sixty-seven patients who underwent surgical resection with curative intent at the centre for primary, non-metastatic, WHO intermediate to high-grade soft tissue sarcoma of the true pelvis from January 2012 through January 2020 were analysed. Establishment of the extent of disease was made by review of pre-treatment imaging and surgical notes. Oncologic endpoints examined were resection margin, recurrence rate, disease-free and overall survival. RESULTS: Rates of complete oncological resection and disease control were similar for tumours with localised or extensive disease. On logistic regression analysis, tumour grade, and a negative resection margin (R0) correlated with the risk of recurrence (p=<0.05). On further multinomial analysis, R0 resection was associated with improved local control, but not metastatic relapse (p = 0.003). 5-year local recurrence-free and distant metastasis-free survival were 61.3% and 67.1%, respectively. Five and 10-year overall survival were 64% and 36%, respectively. Age >50 years and high tumour grade were associated with a worse outcome (p < 0.05). CONCLUSIONS: When potentially curative surgery is performed for pelvic sarcoma, disease-extent does not influence oncologic outcomes. While a complete oncologic resection determines the risk of local recurrence, tumour grade and metastatic relapse remain primary prognostic determinants for overall survival.
Asunto(s)
Pelvis Menor , Sarcoma , Humanos , Persona de Mediana Edad , Pelvis Menor/patología , Márgenes de Escisión , Estudios Retrospectivos , Recurrencia Local de Neoplasia/cirugía , Sarcoma/patología , Pelvis/patología , BiologíaRESUMEN
A 63-year-old postmenopausal woman was referred for a mass on MRI: a well-defined 13 cm hyperechoic mass with high fat content. Exploratory laparotomy revealed normal ovaries and an enlarged uterus; hysterectomy was performed. Histological examination found uterine lipoleiomyoma, a rare benign type of uterine myoma.
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Leiomioma/patología , Pelvis Menor/patología , Lipoma/patología , Anomalías Urogenitales/patología , Anomalías Urogenitales/cirugía , Neoplasias Uterinas/patología , Neoplasias Uterinas/cirugía , Útero/anomalías , Femenino , Humanos , Histerectomía , Laparotomía , Leiomioma/diagnóstico , Lipoma/diagnóstico , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias Uterinas/diagnóstico , Útero/patología , Útero/cirugíaRESUMEN
Realistic models to understand the developmental appearance of the pelvic nervous system in mammals are scarce. We visualized the development of the inferior hypogastric plexus and its preganglionic connections in human embryos at 4-8 weeks post-fertilization, using Amira 3D reconstruction and Cinema 4D-remodelling software. We defined the embryonic lesser pelvis as the pelvic area caudal to both umbilical arteries and containing the hindgut. Neural crest cells (NCCs) appeared dorsolateral to the median sacral artery near vertebra S1 at ~5 weeks and had extended to vertebra S5 1 day later. Once para-arterial, NCCs either formed sympathetic ganglia or continued to migrate ventrally to the pre-arterial region, where they formed large bilateral inferior hypogastric ganglionic cell clusters (IHGCs). Unlike more cranial pre-aortic plexuses, both IHGCs did not merge because the 'pelvic pouch', a temporary caudal extension of the peritoneal cavity, interposed. Although NCCs in the sacral area started to migrate later, they reached their pre-arterial position simultaneously with the NCCs in the thoracolumbar regions. Accordingly, the superior hypogastric nerve, a caudal extension of the lumbar splanchnic nerves along the superior rectal artery, contacted the IHGCs only 1 day later than the lumbar splanchnic nerves contacted the inferior mesenteric ganglion. The superior hypogastric nerve subsequently splits to become the superior hypogastric plexus. The IHGCs had two additional sources of preganglionic innervation, of which the pelvic splanchnic nerves arrived at ~6.5 weeks and the sacral splanchnic nerves only at ~8 weeks. After all preganglionic connections had formed, separate parts of the inferior hypogastric plexus formed at the bladder neck and distal hindgut.
Asunto(s)
Desarrollo Embrionario/fisiología , Plexo Hipogástrico/embriología , Pelvis Menor/inervación , Cresta Neural/citología , Sistema Nervioso Simpático/embriología , Humanos , Pelvis Menor/embriologíaRESUMEN
As useful and necessary as radiotherapy may be, it is associated with irreversible long-term adverse effects including loss of bladder function. In the majority of cases the small bowel, sigmoid rectum and ureter are also affected. The extent of injury depends on the irradiated area, the applied dose and the quality of application. Three factors are essential when choosing a urinary diversion: the length of functional ureter, the position of the bowel outside of the irradiated area and the type of diversion. A continent diversion is best performed through a ascending-transverse or transverse-descending colon pouch. The efferent segment is diverted through the umbilicus. The simplest technique for an incontinent diversion is a conduit using the ascending colon or the right colon flexure. If the length of the ureter does not suffice for such a conduit, the ideal solution is a transverse conduit, as this conduit can be attached to both renal pelves, while simultaneously allowing free choice of the lateral location of the stoma. In case of an exenteration, a double stoma on one side of the body should be avoided in order to prevent maintenance issues.
Asunto(s)
Pelvis Menor/efectos de la radiación , Pelvis/efectos de la radiación , Traumatismos por Radiación , Derivación Urinaria , Colon , Humanos , UréterRESUMEN
BACKGROUND: The transanal approach to ileal pouch-anal anastomosis [Ta-IPAA] provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis [UC]. The aim of this study was to assess the long-term functional outcomes after Ta-IPAA vs transabdominal IPAA [Abd-IPAA] in UC. METHODS: A multicentre cohort analysis was performed between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL [Cleveland global quality of life] score at 12 months with a functioning pouch was considered the primary end point. RESULTS: A total of 374 patients [100 Ta-IPAA vs 274 Abd-IPAA] were included. Ta-IPAA demonstrated a comparable overall quality of life [CGQL score] to Abd-IPAA [0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p = 0.1]. Quality of life [7.71 ± 1.17 vs 7.30 ± 1.46; p = 0.04] and energy-level items [7.16 ± 1.52 vs 6.66 ± 1.68; p = 0.03] were significantly better after Ta-IPAA, while the quality of health item was comparable [7.68 ± 1.26 vs 7.64 ± 1.44; p = 0.96]. Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies [>10/24 h: 22% vs 21%; p = 1.0] and the rate of a single episode of major incontinence during the following 12-month period [27% vs 26%; p = 0.89] were similar. The differences in 30-day morbidity rates [33% vs 41%; p = 0.2] and anastomotic leak rates were not significant [6% vs 13%; p = 0.09]. CONCLUSIONS: This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.
Asunto(s)
Pared Abdominal/cirugía , Canal Anal/cirugía , Fuga Anastomótica , Colitis Ulcerosa/cirugía , Efectos Adversos a Largo Plazo , Complicaciones Posoperatorias , Proctocolectomía Restauradora , Calidad de Vida , Adulto , Fuga Anastomótica/diagnóstico , Fuga Anastomótica/etiología , Fuga Anastomótica/cirugía , Reservorios Cólicos/efectos adversos , Investigación sobre la Eficacia Comparativa , Europa (Continente) , Femenino , Humanos , Pelvis Menor/cirugía , Efectos Adversos a Largo Plazo/fisiopatología , Efectos Adversos a Largo Plazo/psicología , Masculino , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Proctocolectomía Restauradora/efectos adversos , Proctocolectomía Restauradora/métodos , Recuperación de la Función , Reoperación/métodos , Reoperación/estadística & datos numéricosRESUMEN
OBJECTIVE: The study was aimed at assessing the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux with the use of reference methods of examination. PATIENTS AND METHODS: We examines a total of 43 female patients (aged 41.5±5.2 years) presenting with pelvic varicose veins and subjected to phlebectomy on the external genitalia, perineum and lower limbs. All women had no evidence of pelvic venous plethora. All women underwent the following examinations: ultrasonographic angioscanning of pelvic and lower-limb veins, emission computed tomography of pelvic veins prior to operation, as well as 1, 6 and 12 months after surgical interventions. We evaluated efficacy of phlebectomy in elimination of pelvioperineal reflux and varicose syndrome, the frequency of detecting valvular insufficiency of pelvic and lower-limb veins, dynamics of the coefficient of pelvic congestion syndrome in the immediate and remote postoperative periods. RESULTS AND DISCUSSION: No cases of relapses of valvular, perineal varicosity, repeat appearance of varicose veins on the lower extremities, occurrence of signs of pelvic venous congestion were revealed. The frequency of detecting valvular insufficiency of the parametrial, uterine, gonadal and iliac veins remained unchanged. The coefficient of pelvic congestion syndrome did not alter either (Cpcs=0.8±0.11 at baseline versus Cpcs=0.78±0.1 after 12 months). CONCLUSION: The obtained results are indicative of a steady state of the venous outflow from the small pelvis in women with pelvic varicose veins and pelvioperineal reflux after surgical removal of vulvar, perineal and superficial femoral veins.
Asunto(s)
Embolización Terapéutica , Pelvis Menor , Várices/cirugía , Procedimientos Quirúrgicos Vasculares , Insuficiencia Venosa/cirugía , Adulto , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Femenino , Humanos , Pelvis Menor/irrigación sanguínea , Pelvis Menor/fisiopatología , Extremidad Inferior/irrigación sanguínea , Masculino , Persona de Mediana Edad , Flujo Sanguíneo Regional , Tomografía Computarizada de Emisión/métodos , Resultado del Tratamiento , Ultrasonografía Doppler Dúplex/métodos , Várices/diagnóstico , Procedimientos Quirúrgicos Vasculares/efectos adversos , Procedimientos Quirúrgicos Vasculares/métodos , Insuficiencia Venosa/diagnósticoRESUMEN
Preclinical studies indicate that an optimal diet during pelvic radiotherapy may be able to prevent radiation-induced survivorship diseases that diminish cancer survivors' intestinal health. We do not yet know what this optimal diet might be because scientific studies needed to determine what dietary advice might best be given to patients during treatment. Oncology clinics in Sweden were contacted to determine the nature of dietary advice given to gynaecological and prostate cancer patients at each clinic before, during and after radiotherapy. Reports from these clinics revealed that dietary advice given to patients differs from one clinic to another. This was as expected, since it was known that the scientific evidence needed to identify the best possible diet is not yet available. Clinical studies of the effects of different diets are urgently needed if we are to prevent survivorship diseases that decrease intestinal health.
Asunto(s)
Servicios Dietéticos/normas , Neoplasias de los Genitales Femeninos/radioterapia , Neoplasias de la Próstata/radioterapia , Traumatismos por Radiación/prevención & control , Radioterapia/efectos adversos , Antidiarreicos/administración & dosificación , Catárticos/administración & dosificación , Dieta con Restricción de Grasas , Fibras de la Dieta/administración & dosificación , Femenino , Humanos , Pelvis Menor/efectos de la radiación , Masculino , Comidas , Enfermeras y Enfermeros , Nutricionistas , Probióticos/administración & dosificación , Encuestas y Cuestionarios , SueciaRESUMEN
The problem of chronic venous insufficiency in women during pregnancy is of current concern. A total of 115 pregnant women in the first, second and third trimesters of gestation were examined in a stage-wise manner. During the first stage we conducted a comprehensive clinical study with the obligatory consultation by the obstetrician-gynaecologist. At the second stage, all women were subjected to ultrasonographic examination of the venous system of both lower extremities and the small pelvis. Studying the diameters of the deep veins of the right and left lower limbs, as well as the paired veins of the small pelvis demonstrated no statistically significant differences, which made it possible to evaluate these parameters as a whole. In all pregnant women, the lumen of the examined vessels was uniform, with the veins being patent, compliant, stained on colour Doppler mapping. Respiration-synchronized, phasic blood flow was registered. In the course of the study it was revealed that the diameter of the veins of the lower limbs and small pelvis increased as gestation proceeded. The findings of ultrasonographic angioscanning showed that by the third trimester of pregnancy the diameter of the femoral vein was 1.5-fold larger and that of the popliteal vein was 1.4-fold larger. The diameter of the veins of the pampiniform plexus of the ovaries during gestation was noted to have increased 1.13-fold. This was accompanied and followed by deterioration of tonic-and-elastic properties of the venous wall and the development by the third trimester of valvular insufficiency with the emergence of venous congestion. Seventeen (16%) women were found to have varicose syndrome. The above mentioned alterations of venous haemodynamics appeared to lead to impairment of blood flow in the affected veins and to the emergence of thrombogenic zones in the valvular sinuses. Of the 115 women examined, 77 (67%) were found to have degree 1 sludge and 36 (31.3%) had degree 2 sludge, with the D-dimer level in these women having increased to 773.3±37.5 ng/ml. Degree 3 sludge was observed in 2 (1.7%) women previously operated on for acute venous thrombosis. Their D-dimer level amounted to 954.3±43.2 ng/ml. It was demonstrated that studying the valvular sinuses for detection of sludge during examination of pregnant women allowed obstetricians-gynaecologists and physicians of ultrasonographic diagnosis to form risk groups for the development of deep vein thrombosis and to timely take appropriate measures aimed at prevention of the pathology concerned.
Asunto(s)
Vena Femoral/diagnóstico por imagen , Pelvis Menor/irrigación sanguínea , Extremidad Inferior/irrigación sanguínea , Vena Poplítea/diagnóstico por imagen , Ultrasonografía Doppler Dúplex/métodos , Várices/diagnóstico por imagen , Insuficiencia Venosa , Trombosis de la Vena , Adulto , Femenino , Vena Femoral/fisiopatología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Vena Poplítea/fisiopatología , Embarazo , Trimestres del Embarazo/fisiología , Reproducibilidad de los Resultados , Medición de Riesgo , Várices/fisiopatología , Insuficiencia Venosa/complicaciones , Insuficiencia Venosa/diagnóstico , Insuficiencia Venosa/fisiopatología , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/etiología , Trombosis de la Vena/prevención & controlRESUMEN
Paralysis of the femoral nerve secondary to iliopsoas haematoma is a rare post-traumatic complication. Because of the large differential diagnosis, a high level of suspicion is required for its early recognition. Treatment modalities are controversial due to the rarity of this entity. An 18-year-old student presented with complete paralysis of the knee extensors and a sensory deficit on the anterior side of the thigh 5 weeks after a sport accident. MRI of the lesser pelvis showed an iliopsoas haematoma. Surgical decompression was performed and recovery was complete at 6 months of follow-up.
Asunto(s)
Neuropatía Femoral/etiología , Hematoma/diagnóstico por imagen , Parálisis/etiología , Músculos Psoas/lesiones , Adolescente , Diagnóstico Diferencial , Hematoma/cirugía , Humanos , Pelvis Menor/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Músculos Psoas/diagnóstico por imagen , Músculos Psoas/cirugía , Resultado del TratamientoRESUMEN
The article is a literature review presenting modern data on applied anatomy of the pelvic veins, diagnosis and treatment of pelvic varicose veins, pelviperineal reflux and vulvar varicosity, lower limb varicose veins, which were caused by pathological reflux from varicose pelvic veins. Presented is the information on tactical approaches in treatment of combined varicose veins of the pelvis and lower limbs, surgical decision-making for correction of pelviperineal reflux, methods of operative and phlebosclerosing interventions on pelvic and superficial veins of the perineum and lower limbs.
Asunto(s)
Pelvis Menor/irrigación sanguínea , Extremidad Inferior/irrigación sanguínea , Escleroterapia/métodos , Várices , Procedimientos Quirúrgicos Vasculares/métodos , Insuficiencia Venosa , Enfermedades de la Vulva , Femenino , Humanos , Selección de Paciente , Várices/complicaciones , Várices/cirugía , Insuficiencia Venosa/etiología , Insuficiencia Venosa/terapia , Enfermedades de la Vulva/etiología , Enfermedades de la Vulva/prevención & controlRESUMEN
The pelvis and the spine form a system balancing human skeleton. Within this system, the pelvis adapts to age-related changes in the spine. Previous studies were predominantly focused on changes of pelvic parameters in the sagittal plane. The aim of this study was to reveal age-related changes of lesser pelvic dimensions at different levels of the pelvic cavity in the sagittal and coronal planes and to explore sexual dimorphism in age-related tendencies. The computed tomography pelvimetry was performed on the three-dimensional workstation. The research sample included 211 females aged 18 to 84 years and 181 males aged 18 to 82 years, who underwent an examination at the Riga East University Hospital, Clinical Center “Gailezers,” Latvia. Three pelvic angles and transverse and sagittal diameters of the lesser pelvis were measured at four levels: the inlet, two axial planes in the mid-cavity, and the outlet. The results demonstrated that more pronounced age-related changes occurred in the inlet and the outlet of the lesser pelvis. The mid-cavity was less changing. The transverse diameter between acetabular centers and the sagittal diameter at the level of ischial spines were independent of age. In general, the common age-related trends were observed for pelvic parameters in females and males. A single exception was the proportion of diameters at the level of ischial spines, which decreased in males only. For parameters associated with pelvic floor diseases, age-related changes occurred in the direction of pathology.
Asunto(s)
Femenino , Humanos , Masculino , Acetábulo , Envejecimiento , Bahías , Letonia , Pelvis Menor , Patología , Trastornos del Suelo Pélvico , Pelvimetría , Pelvis , Esqueleto , Columna VertebralRESUMEN
A 17-year-old young man presented at our clinic with asymptomatic microhematuria. Ultrasonography and computer tomography found an intraperitoneal lesion of unknown dignity located on top of the bladder. Surgical exploration and histological examination confirmed the diagnosis of a secondary pelvic spleen, a lien bipartitus.
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Coristoma/diagnóstico por imagen , Hematuria/diagnóstico por imagen , Hematuria/etiología , Pelvis Menor/diagnóstico por imagen , Páncreas , Enfermedades de la Vejiga Urinaria/diagnóstico por imagen , Adolescente , Coristoma/patología , Diagnóstico Diferencial , Hematuria/diagnóstico , Humanos , Pelvis Menor/patología , Masculino , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos , Enfermedades de la Vejiga Urinaria/patologíaAsunto(s)
Procedimientos Quirúrgicos Dermatologicos/métodos , Lipomatosis Simétrica Múltiple/etiología , Esclerodermia Localizada/complicaciones , Femenino , Humanos , Pelvis Menor , Lipomatosis Simétrica Múltiple/diagnóstico , Lipomatosis Simétrica Múltiple/cirugía , Persona de Mediana Edad , Esclerodermia Localizada/diagnósticoRESUMEN
The authors studied peculiarities of pelvic organs lesions in patients presenting with secondary small pelvic varicose veins (SPVV) induced by endured thrombosis of iliac veins. The study included a total of 70 patients after endured thrombosis of iliac veins verified by radiodiagnostic methods. The average duration of thrombosis amounted to 3.8 years. The patients were subdivided into two groups. The Study Group comprised 48 patients presenting with small pelvic varicose veins revealed by duplex scanning; the Control Group was composed of 22 patients with no varicose pelvic veins. It was determined that characteristic features of patients with secondary SPVV having developed after iliac veins thrombosis included chronic pelvic pain, dilatation of cavernous veins of the rectum, inguinal vein varicosity and varicose veins of the groin and anterior abdominal wall. Formation of secondary SPVV after endured iliac vein thrombosis leads to disorders of pelvic organs, similar to those in primary varicosity, but more often being functional. Endured iliac veins thrombosis in formation of secondary SPVV leads to urination impairments with prevalence of moderately pronounced symptomatology. Small pelvic organs dysfunction in women with secondary SPVV due to endured iliac veins thrombosis manifests itself in dyspareunia, leukorrhea, and dysmenorrhea.
Asunto(s)
Dismenorrea , Vena Ilíaca/cirugía , Dolor Pélvico , Trastornos Urinarios , Várices , Insuficiencia Venosa , Trombosis de la Vena/complicaciones , Dismenorrea/epidemiología , Dismenorrea/etiología , Dismenorrea/fisiopatología , Femenino , Humanos , Pelvis Menor/irrigación sanguínea , Masculino , Persona de Mediana Edad , Evaluación del Resultado de la Atención al Paciente , Dolor Pélvico/etiología , Dolor Pélvico/fisiopatología , Flebografía/métodos , Federación de Rusia/epidemiología , Ultrasonografía Doppler Dúplex/métodos , Trastornos Urinarios/epidemiología , Trastornos Urinarios/etiología , Trastornos Urinarios/fisiopatología , Várices/diagnóstico , Várices/epidemiología , Várices/etiología , Várices/fisiopatología , Venas/fisiopatología , Insuficiencia Venosa/diagnóstico , Insuficiencia Venosa/epidemiología , Insuficiencia Venosa/etiología , Insuficiencia Venosa/fisiopatología , Trombosis de la Vena/diagnóstico por imagenRESUMEN
Endometriosis is a chronic disease affecting mainly women of the reproductive age. Its most common manifestations include impaired fecundity, pelvic pain, and dyschezia. Laparoscopic removal of endometriotic foci remains to be the gold standard for the treatment of endometriosis. More effective techniques of endoscopic approach-among others, laser application-are continually being developed. The aim of the study was to evaluate the efficacy of laparoscopic treatment with the use of CO2 laser ablation vs. electroablation with regard to pain complaints in the affected patients. The study included 48 women (aged 22-42) with varying degrees of endometriosis of the lesser pelvis. The Numeric Rating Scale (NRS) was used to evaluate pain intensity before the surgery in all patients, followed by either laser ablation or electroablation of the endometriotic foci. The results of the laparoscopic treatment were monitored after 3 and 6 months postoperatively. p value of 0.05 was considered to be statistically significant. Patients from both groups reported less intensive pain before/during menstruation (dysmenorrhea) 6 months postoperatively, with more distinct tendency in the electroablation group (p = 0.004) as compared to the laser ablation group (p = 0.025). Despite the initial improvement reported at the 3-month checkup (p = 0.008), 6 months postoperatively, a statistically significant increase in pain intensity was noted in both groups (p = 0.016 and p = 0.032 for CO2 laser ablation and electroablation, respectively). Both surgical methods seem to be effective only in the treatment of endometriosis-related dysmenorrhea, whereas the intensity of other pain complaints (dyspareunia, dysuria, dyschezia, pelvic pain syndrome (PPS)) has remained on the same level.
Asunto(s)
Dispareunia/terapia , Endometriosis/cirugía , Terapia por Láser , Láseres de Gas/uso terapéutico , Dolor Pélvico/terapia , Adulto , Endometriosis/patología , Femenino , Humanos , Laparoscopía , Pelvis Menor/patología , Pelvis Menor/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To perfect and estimate the possibilities of using a mini-invasive diagnostic procedure under magnetic resonance (MR) guidance in the complex anatomic situations in cases of pathological small pelvic changes of unknown origin. MATERIAL AND METHODS: Ten small pelvic interventions were made under MR guidance. The indications for bone biopsy under MR guidance were poor visualization of bone changes or their absence during radiography, including computed tomography. Small pelvic organ and soft tissue biopsies were carried out in the situations of complex location of pathological changes adjacent to critical organs, large vascular and neural structures. All interventions were done using a high-field MR scanner. Freehand biopsy was performed in a stepwise fashion under axial and sagittal T2-weighted image control. RESULTS: Informative histological material was obtained in 100% of cases. No complications were observed. CONCLUSIONS: It became possible to verify the diagnosis based on morphological findings and to timely determine management tactics only by target biopsy under MR guidance in these 10 patients with small pelvic changes of unknown origin.
Asunto(s)
Biopsia con Aguja , Pelvis Menor/patología , Imagen por Resonancia Magnética Intervencional/métodos , Neoplasias Pélvicas/diagnóstico , Adulto , Biopsia con Aguja/instrumentación , Biopsia con Aguja/métodos , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pélvicas/clasificación , Reproducibilidad de los ResultadosRESUMEN
Retropubic tumours without contact to bones or surrounding tissues are extremely rare with only 22 cases being reported in the literature. The majority of tumours described within these reports are osteochondromas in 17 cases, 2 cases of leiomyoma and one case of each fibroma, fibrosarcoma and nodular fasciitis. We now report the case of a 52-year-old-man with a retropubic ganglion cyst, which was resected "in toto" by laparoscopy.
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Coristoma/diagnóstico , Ganglión/diagnóstico , Pelvis Menor , Sínfisis Pubiana , Coristoma/patología , Coristoma/cirugía , Diagnóstico Diferencial , Disuria/etiología , Endosonografía , Ganglión/patología , Ganglión/cirugía , Humanos , Laparoscopía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Prostatitis/etiología , Tomografía Computarizada por Rayos XRESUMEN
The authors analyzed the experience at the period from September 2000 to January 2014. The total exenterations of the small pelvis were performed on 23 patients (12 men and 11 women) at the age from 37 to 71 years old. Supralevator total exenterations with full visceral reconstruction were carried out in 13 cases out of 23. Total infralevator pelvic exenterations were used in 10 cases. There wasn't the intraoperative lethality. Patients (3 cases) died in postoperative period. Postoperative complications developed in 10 patients, though serious complications, which required an application of surgical strategy were noted only in 3 cases. The mean life span consisted of 29 months. The performance of total exenteration of the small pelvis considerably increased the life span of the patients and in case of application of reconstructive methods allowed restoration of quality of life to high level and obtaining moral, psychological and social rehabilitation.