RESUMO
Three cases of urethral duplication are described--two complete and one incomplete. The surgical approaches used in 2 of the 3 cases are described, the third not having come to definitive surgery as yet. In the patient with an incomplete urethral duplication the accessory urethra and associated ventral preputial hood were excised. A repair of the complete duplication was devised in which an end-to-side urethrourethrostomy and penile plastic revision were accomplished. The literature is reviewed and a new classification system for urethral duplication is proposed.
Assuntos
Uretra/anormalidades , Uretra/cirurgia , Humanos , Recém-Nascido , Masculino , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
A case is described of a baby girl born with such a large multicystic kidney that it partially obstructed the contralateral ureter, made feeding impossible due to gastric compression, and caused respiratory distress by thoracic cavity compression. Management of the case is described, and a literature review is presented.
Assuntos
Doenças Renais Policísticas/complicações , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Estômago/patologia , Obstrução Ureteral/etiologia , Constrição Patológica/etiologia , Nutrição Enteral , Feminino , Humanos , Recém-Nascido , Nefrectomia , Doenças Renais Policísticas/cirurgia , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Obstrução Ureteral/cirurgiaRESUMO
From 1970 to 1980, 153 patients with stages A2, B1 and B2 prostatic cancer and proved negative pelvic lymph nodes underwent radical prostatectomy (84 underwent radical perineal and 69 underwent radical retropubic prostatectomy). Seventeen patients were lost to followup. Of 136 patients who were followed for 5 years or until death 128 (94 per cent) were alive at 5 years, including 118 (87 per cent) who were without evidence of recurrence. Patients with microscopic invasion of the prostatic capsule have a better outcome at 5 years than those with microscopic involvement of the seminal vesicles. Only 46 of the patients could be assessed at 10 years or had died 6 to 10 years postoperatively. Results at 10 years are considered preliminary, since many more patients will reach the 10-year milestone within the next few years.
Assuntos
Recidiva Local de Neoplasia/mortalidade , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Seguimentos , Humanos , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Neoplasias da Próstata/mortalidade , Fatores de TempoRESUMO
A technique for partial nephrectomy using a combination of an Ultrasonic Surgical Aspirator and a neodymium:YAG laser provided better hemostasis and decreased total operative time compared to standard methods. Delayed hemorrhage was not seen, and thermal damage to the remaining renal parenchyma was minimal.
Assuntos
Rim/cirurgia , Terapia a Laser , Nefrectomia , Terapia por Ultrassom , Animais , Terapia Combinada , Cães , Hemostasia Cirúrgica , Rim/patologia , SucçãoRESUMO
A Cavitron Ultrasonic Surgical Aspirator (CUSA) was used to isolate and skeletonize parenchymal renal vessels during 20 partial nephrectomies performed on 10 dogs. After isolation of the renal vessels, hemostasis was obtained by direct application of neodymium:YAG laser energy. Blood loss and total operative time were reduced compared to a control series of partial nephrectomies performed with a scalpel. The combination of Cavitron Ultrasonic Surgical Aspirator plus a Nd:YAG laser appears to offer advantages compared to either modality used alone or to standard techniques for partial nephrectomy.
