RESUMO
OBJECTIVE: Approximately one in five patients with ureteropelvic junction stenosis (UPJS) also present with renal or ureteral stones. For patients with UPJS, the European Association of Urology guidelines currently recommend that robot-assisted pyeloplasty (RAP) and pyelolithotomy are performed as two separate procedures. The aim of the present study was to evaluate the feasibility and safety of RAP with concomitant pyelolithotomy (RAP + P) in patients diagnosed with UPJS and renal stones. MATERIALS AND METHODS: In total, 56 RAP procedures and 18 RAP + P procedures were performed between December 2012 and January 2014. Patient records were retrospectively reviewed for operation time (OT), estimated blood loss (EBL), length of hospital stay (LOS), complications, stone burden and stone-free rates at 1, 3 and 6 months following surgery. RESULTS: A significant difference in the OT was demonstrated between RAP and RAP + P, with a median of 120 min [interquartile range (IQR) 100-134 min] and 151 min (IQR 128-185 min), respectively (p < 0.0001). In contrast, no difference in LOS [median 2 days (IQR 2-3 days) vs 3 days (2-4 days), p = 0.50) or EBL [median 0 ml (IQR 0-50 ml) vs 20 ml (0-50 ml), p = 0.64] was observed between RAP and RAP + P. The median total stone burden was 1.5 cm (IQR 1.0-4.3 cm; range 1-10 cm). The stone-free rate at 1, 3 and 6 months was 94%, 83% and 72%, respectively. No grade 3-5 complications were observed in the RAP + P group. CONCLUSIONS: RAP + P can safely be offered to patients with UPJS and renal stones, with an acceptable stone-free rate.
Assuntos
Cálculos Renais/cirurgia , Procedimentos Cirúrgicos Robóticos , Cálculos Ureterais/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos , Adulto , Perda Sanguínea Cirúrgica , Constrição Patológica/complicações , Constrição Patológica/cirurgia , Estudos de Viabilidade , Feminino , Humanos , Cálculos Renais/complicações , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento , Ureter/patologia , Ureter/cirurgia , Cálculos Ureterais/complicações , Obstrução Ureteral/complicações , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodosRESUMO
Ectopic thyroid tissue is a result of abnormal embryologic development and migration of the thyroid gland. It has a prevalence of one per 100,000-300,000, and the risk of malignant transformation in ectopic thyroid tissue is rare. We present a rare case of perivesical ectopic papillary thyroid carcinoma in a 76-year-old man with a normal orthotopic thyroid gland. A total thyroidectomy was performed, and the pathology report showed normal thyroid tissue with no neoplastic involvement. The patient was treated with radioactive iodine, and a control scintigraphy was without any signs of activity.
