Solitary Renal Metastasis Arising from a Pulmonary Adenoid Cystic Carcinoma: A Case Report and Review of the Literature.

Adenoid cystic carcinoma (ACC) is a malignancy affecting the salivary glands and rarely involving the lung. Due to its rarity, primary lung ACC remains incompletely understood. We herein report the case of a 57-year-old female patient who was initially diagnosed with primary lung ACC and was treated by lobectomy. Seven years later, an abdominal computed tomography scan performed in the context of surveillance revealed the presence of a solid lesion arising from the lower pole of the left kidney. The patient underwent left partial nephrectomy, and histopathology confirmed a completely excised metastatic ACC.

Laparoscopic Nephropexy: The Sliding Clip Technique.

Background: Nephroptosis is a clinical condition characterized by symptoms related to an abnormal caudal movement of the kidney. During the past decade, the availability of laparoscopic surgery has led to a revival of interest in nephroptosis. Most of the traditional surgical techniques aim to achieve kidney fixation by placing triangulation sutures between the abdominal wall and the renal capsule. These sutures are often difficult to tie because of the confined working space. Case Presentation: We herein present a case of a 31-year-old female patient who presented with symptomatic right-sided nephroptosis and was managed effectively by laparoscopic nephropexy. We have applied a technical modification to facilitate laparoscopic fixation by utilizing suture and nonabsorbable polymer clips ("sliding clip" technique). Conclusion: Laparoscopic nephropexy is a safe and effective procedure for the management of symptomatic nephroptosis. The "sliding clip" technique is a modification familiar to most urologists that facilitates intracorporeal suturing and adequate renal fixation.

Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures.

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0.007, resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10 cm(3) exhibited a VAS score >3 at 8 h and 24 h (P = 0.050, P = 0.036, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification.