Impacto de los sistemas de nefrometría renal en la valoración de las complicaciones en el tratamiento percutáneo guiado por imagen de las masas renales de pequeño tamaño / Usefulness of renal nephrometry scoring systems in the prediction of complications associated to percutaneous image-guided treatment for small renal masses

Introducción Los tumores renales son un desafío para los profesionales de la salud debido a su creciente prevalencia y complejidad de manejo. El estudio investiga la utilidad de los sistemas de nefrometría renal R.E.N.A.L. score y Padua en la predicción de complicaciones de la crioablación percutánea (CA). Material y métodos El estudio analiza de forma prospectiva a 90 pacientes con carcinoma de células renales (CCR) estadio T1a tratados con crioablación, totalizando 101 tumores. Resultados Se estudiaron 90 pacientes con 101 tumores renales de pequeño tamaño que recibieron terapia crioablativa. Los pacientes tenían una edad media de 68 años y mayoría eran hombres (74,4%). La mayoría de los tumores eran menores a 4 cm (89,1%) y la puntuación media del Padua y R.E.N.A.L. scores fue de 8,65 y 7,35, respectivamente. Se observaron complicaciones en 12 casos. El PADUA y R.E.N.A.L. scores demostraron un poder predictivo moderado (área bajo la curva [AUC] = 0,58 y AUC = 0,63, respectivamente) para las complicaciones poscrioablación. Conclusiones La CA es un tratamiento seguro y efectivo para los tumores renales de pequeño tamaño. Los sistemas de nefrometría renal R.E.N.A.L. y Padua scores tienen un poder predictivo moderado para las complicaciones asociadas a la CA de tumores renales. (AU)

Introduction Due to their increasing prevalence and complex management, renal tumors are challenging for health professionals. The study aims to evaluate the usefulness of R.E.N.A.L. and PADUA nephrometry scores in the prediction of complications after percutaneous cryoablation. Material and methods The study prospectively analyzed 90 patients with 101 stage T1a renal cell carcinoma (RCC) tumors treated with cryoablation. Results Ninety patients with 101 small renal tumors who received cryoablative therapy were investigated. The mean age of the patients was 68 years and 74.4% were male. Most tumors were smaller than 4 cm (89.1%) and the mean PADUA and R.E.N.A.L. scores were 8.65 and 7.35, respectively. Complications were observed in 12 cases. PADUA and R.E.N.A.L. scores demonstrated moderate predictive power (AUC = 0.58 and AUC = 0.63, respectively) for post-cryoablation complications. Conclusions Percutaneous cryoablation is a safe and effective treatment for small renal tumors. The R.E.N.A.L. and PADUA renal nephrometry scores have moderate predictive power for complications associated with percutaneous cryoablation of renal tumors. (AU)

Usefulness of renal nephrometry scoring systems in the prediction of complications associated to percutaneous image-guided treatment for small renal masses.

INTRODUCTION: Due to their increasing prevalence and complex management, renal tumors are challenging for health professionals. The study aims to evaluate the usefulness of R.E.N.A.L. and PADUA nephrometry scores in the prediction of complications after percutaneous cryoablation. MATERIAL AND METHODS: The study prospectively analyzed 90 patients with 101 stage T1a renal cell carcinoma (RCC) tumors treated with cryoablation. RESULTS: Ninety patients with 101 small renal tumors who received cryoablative therapy were investigated. The mean age of the patients was 68 years and 74.4% were male. Most tumors were smaller than 4 cm (89.1%) and the mean PADUA and R.E.N.A.L. scores were 8.65 and 7.35, respectively. Complications were observed in 12 cases. PADUA and R.E.N.A.L. scores demonstrated moderate predictive power (AUC = 0.58 and AUC = 0.63, respectively) for post-cryoablation complications. CONCLUSIONS: Percutaneous cryoablation is a safe and effective treatment for small renal tumors. The R.E.N.A.L. and PADUA renal nephrometry scores have moderate predictive power for complications associated with percutaneous cryoablation of renal tumors.

Displasia cifomélica: hallazgos clínicos y radiológicos / Kyphomelic displasia: clinical and radiological fundings

La dysplasia cifomélica es una malformación ósea rara, con herencia autonómica recesiva. Se caracteriza por una marcada angulación congénita de los fémures, que se hallan a su vez acortados y ensanchados. Otros hallazgos son: acortamiento de otros huesos largos, metáfisis irregulares, tórax estrecho e hipoplasia acetabular. Son niños con micrognatia, estatura corta y menos frecuentemente paladar ojival. Algunos autores han descrito una variabilidad amplia en el fenotipo de este síndrome (AU)

Kyphomelic displasia is a rare and autosomal recesive inherited bone dysplasia. The most striking features is congenital severe angulation of short and broad femora. Additional characteristic features are bowing and shortening of other long bones, irregular methaphyses, small thoracic cage and hypoplastic acetabula. These children have micrognathia, short stature and rarely cleft palate. Some authors have described a wide phenotypic variability of this syndrome (AU)

[Selective intra-arterial embolization in spontaneous rupture of hepatocarcinoma]. / Embolización selectiva intraarterial en ruptura espontánea de hepatocarcinoma.

We present the case of a patient with no previous history of liver disease, who required urgent medical care due to dizziness and hypotension. A diagnosis of hemoperitoneum was made by means of ultrasound and fine needle aspiration. The hemoperitoneum source was the spontaneous rupture of a liver tumor whose CT axial scan appearance was suggestive of hepatocarcinoma. The hemorrhage was controlled using intraarterial selective embolization. The rupture of a hepatocarcinoma is a surgical emergency with high mortality. Its early detection using an adequate diagnostic sequence, allows the surgeon to establish a therapeutic procedure as soon possible. Selective intraarterial embolization with alcohol has proved to be an effective procedure in the management of this kind of hemorrhage with a minimum surgical preparation, and allows further surgical interventions. Nevertheless mortality is still high due to the severity of the clinical entity.

[Surgical treatment of hypertrophic stenosis of the pylorus at a general surgery service]. / Tratamiento quirúrgico de la estenosis hipertrófica del píloro en un servicio de cirugía general.

The authors purpose was to demonstrate that pyloromyotomy can be successfully carried out by nonspecialist surgeons. Eighty three cases admitted over a twelve-year period to the Department of Pediatrics of Montecelo Hospital, a district general hospital, were reviewed. Extramucosal pyloromyotomy was performed by general surgeons under general anaesthesia in all cases. There were no deaths. Three infants had postoperative complications and required treatment. All cases underwent prophylactic antibiotics and no wound infections were recorded. When compared with other published series, our study shows that extramucosal pyloromyotomy can be carried out safely by general surgeons and that prophylactic antibiotic treatment can decrease morbidity. Postoperative complications are not related to damage of the duodenal mucosa or the type of skin incision.