Renal cell carcinoma, part 3.

ABSTRACT: Renal cell carcinoma (RCC) accounts for most renal malignancies. This article, the last in a three-part series, presents treatment options for RCC using the American Joint Committee on Cancer Tumor, Node, and Metastasis staging system as a framework, as well as nursing-care options for patients undergoing partial or radical nephrectomy.

Posoperatorio del donante vivo de riñón: diferencia con pacientes sometidos a nefroctomías laparoscópicas por otras causas / No disponible

Debido al incremento de la nefrectomía laparoscópica para trasplante renal de donantes vivos en nuestro hospital en los últimos años (en 2017, 332 trasplantes renales de donante vivo, de los que 47 se hicieron en Andalucía y 17 de ellos en nuestro centro), se ha realizado un estudio prospectivo en el cual se analizaron, con 6 variables, el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los donantes vivos con respecto al resto de pacientes que se someten al mismo procedimiento por otras causas en nuestra unidad. El objetivo principal del estudio es analizar las implicaciones y el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los diferentes procesos. Se parte de la hipótesis de que las implicaciones que tiene el donante vivo afectarán al desarrollo de su posoperatorio (mayor dolor, mayor estancia hospitalaria...), comparado con el resto de pacientes que se someten a la misma intervención por otros motivos. Se identificó en este estudio que este tipo de cirugía implica mayor estancia hospitalaria, con respecto a la misma cirugía por otros motivos, pero no existe un resultado en el número de pacientes estudiados de mayor dolor en estos pacientes con respecto a los otros citados. Mostraremos los cuidados enfermeros que seguimos en nuestra unidad con estos pacientes. Para ello tomaremos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros, así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC)

Due to the increase of laparoscopic nephrectomy in live donors for renal transplantation during the last years in our hospital (in 2017, 332 live donor renal transplants, of these 47 were done in Andalusia, and 17 in our hospital). A prospective study was conducted to analyse 6 variables, the Impact of postoperative laparoscopic nephrectomy in live donors compared to those patients who underwent the same procedure for different reasons in our unit. The primary aim of the study is to examine the implications and impact of postoperative laparoscopic nephrectomy in different processes. It is assumed that the live donor's implications will affect the postoperative period (pain, length of hospital stay...), compared to the rest of the patients who undergo the same procedure for different reasons. A study identified that this type of surgery involves unnecessarily prolonged stay in hospital, with regards to the same surgery but for different reasons. However, there is no evidence of difference between the number of patients studied with severe pain and the aboye mentioned. We will show the nursing care that we follow with these patients in our unit. We will take as reference Gordon's functional health patterns, identifying nursing diagnosis as well as the nursing outcomes classification (NOC) and nursing interventions

The expression and function of Frizzled-7 in human renal cell Carcinoma

Purpose: Wnt/b-catenin has emerged as an important signal pathway in renal cell carcinoma (RCC) pathogenesis. Frizzled 7 (Fzd7) is a member of Frizzled (Fzd) receptor family which binds with Wnt ligands and transduces canonical and non-canonical pathways. However, the expression of Fzd7 in human RCC is poorly investigated. Methods: 53 RCC tissues and peri-tumor tissues were collected from the patients treated with radical nephrectomy. The expression of Fzd7 was investigated by immunohistochemical staining. Three RCC cells were transfected with Fzd7shRNA and GFPshRNA to investigate the function of Fzd7 in RCC cells. Results: The immunohistochemical analysis showed that Fzd7 protein expression level was significantly increased in RCC tissues when compared with peri-tumor tissues, which suggested that Fzd7 might be involved in the formation of tumors. However, the Fzd7 expression was not correlated with clinicopathological parameters. Three RCC cell lines: 786-O, Caki-1, and OS-RC-2 also expressed Fzd7. With Fzd7 expression being interfered by shRNA, the RCC cell proliferation was mildly decreased. Wnt3a could stimulate the RCC cells proliferation, but the stimulation was decreased when Fzd7 expression was interfered. Restoring the Fzd7 expression led to the proliferation stimulation effect of Wnt3a being restored. Conclusions: This paper suggests that Fzd7 may act as one of the molecules that take part in the course of RCC formation. Fzd7 can be activated by Wnt3a to stimulate cell proliferation (AU)

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Diagnósticos e intervenciones enfermeras intraoperatorias en pacientes intervenidos de nefrectomía simple / No disponible

A través del presente artículo pretendemos dar difusión a un protocolo de actuación creado en la unidad quirúrgica del Hospital Alto Guadalquivir de Andújar para los pacientes intervenidos de nefrectomía simple. A la misma vez que podemos poner de manifiesto que la labor de enfermería en el área quirúrgica y las actividades que realiza, pueden ser tipificadas con las taxonomías NANDA-NIC, consiguiendo que los cuidados que se presten a este tipo de pacientes sean de calidad y estandarizados, debido a la necesidad de evitar complicaciones y garantizar una asistencia adecuada en este tipo de intervención. Este hecho aporta mayor seguridad al paciente y a los propios profesionales, así como una reducción de la variabilidad en la práctica asistencial enfermera (AU)

Through this article we try to disseminate a protocol established in the surgical unit of the Hospital Alto Guadalquivir Andujar, for patients who underwent simple nephrectomy. At the same time we are able to show that the work of nurses in the surgical area and the activities can be typified with NANDA-NIC Taxonomies, getting the care that is appropriate for this type of patients are of quality and standardized, due to the need to avoid complications and ensure appropriate assistance in this type of intervention. This provides greater patient safety and the professionals as well as a reduction of the variability in clinical practice nurse (AU)

Dificultad para conseguir un Acceso Vascular para hemodiálisis: Caso Clínico: 9 años en Hemodiálisis, 15 Accesos Vasculares / Difficulty in achieving Vascular Access for haemodialysis: Case Study: 9 years on Haemodialysis, 15 Vascular Accesses

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Radical nephrectomy with inferior vena cava (IVC) thrombectomy: implications for post-operative nursing care.

The surgery required to remove a renal cell carcinoma with inferior vena cava (IVC) tumor thrombus is complex. IVC tumor thrombus is a complicating factor that occurs in 4% to 10% of patients with renal cell carcinoma. Nurses need to understand this surgical procedure and its inherent risks to proactively and successfully manage the patient's post-operative care and discharge plan.

Anesthetic management of an infant undergoing radical nephrectomy for Wilms tumor: a case report.

Wilms tumor (WT), also called nephroblastoma, is a solid, malignant renal mass that can sometimes grow so large it spreads outside the kidney and invades other structures. Most experts recommend complete tumor resection as a primary intervention. The clinical manifestations caused by the WT most significantly hypertension, can appear as a barrage of pathophysiological events to the nurse anesthetist. The case presented involves an 8-week-old infant who underwent a radical nephrectomy because of a WT. The occurrence, symptoms, pathophysiology, and intraoperative anesthetic management of WT are discussed.

Nefrectomía radical abierta y laparoscópica: estudio comparativo de cuidados de enfermería y calidad de vida / No disponible

En la Fundación Puigvert se ha introducido la nefrectomía laparoscópica como innovación quirúrgica durante el año 2001. Desde enero de 2001 se emplean ambas técnicas quirúrgicas simultáneamente, disminuyendo progresivamente el número de nefrectomías abiertas en beneficio de la cirugía laparoscópica, lo cual nos exige no sólo conocer las diferencias clínicas existentes entre ambas, sino discernirlos cuidados de enfermería a proporcionar según la demanda asistencial. Como equipo de enfermería consideramos que es imprescindible poseer un cuerpo de conocimientos, habilidades y actitudes que se adapten a los cambios e innovaciones. De este modo podremos identificar necesidades de salud, planificar cuidados de enfermería adecuados, prevenir complicaciones y contribuir a la adaptación del paciente a la vida diaria fomentando la independencia en todas sus necesidades según el modelo conceptual de Virginia Henderson. El objetivo de este estudio es describir desde un punto de vista comparativo la evolución posquirúrgica de la nefrectomía radical abierta y laparoscópica durante la hospitalización y el alta domiciliaria, en función de los cuidados de enfermería requeridos según el modelo conceptual de Virginia Henderson (AU)

In the Puigvert Foundation the laparoscopic nephrectomy has been introduced as surgical innovation during 2001. From January 2001both surgical techniques are used simultaneously, decreasing progressively the number of open nephrectomies for the benefit of the laparoscopic surgery, which requires that us not only to know the existing clinical differences between both, but to discern the cares of nursing to provide according to the demand. We, as a nursing team, consider that it is essential to possess a corps of knowledge, skills and attitudes that could be adapted to changes and innovations. In this way, we will be able to identify health needs, plan adequate nursing cares, prevent complications, and contribute to the adaptation of the patient to daily life encouraging the independence in all their needs according to the conceptual model of Virginia Henderson. The goal of this study is to describe from a comparative point of view the post-surgical evolution of the open radical nephrectomy and laparoscopic during the hospitalization and the house discharge, according to the nursing cares required according to the conceptual model of Virginia Henderson (AU)

Estudio comparativo entre nefrectomía radical abierta y laparoscópica: experiencia inicial / No disponible

El término laparoscopia se le da a un grupo de operaciones realizadas con la ayuda de una cámara colocada en el abdomen. Su desarrollo, en estos últimos años, ha suscitado estudios que la comparan con la cirugía convencional. Los resultados han favorecido a la laparoscopia haciendo de esta técnica quirúrgica un procedimiento de primera elección. En este artículo queda manifiesto que se hace competitiva en costes y gasto hospitalario reduciendo el tiempo de estancia y complicaciones derivadas del abordaje quirúrgico (AU)

The term laparoscopy occurs him to a surgery group made with the aid of a placed camera in the abdomen. Its development, in recent years, has provoked studies that compare it with the conventional surgery. The results have favored to the laparoscopia doing of this surgical technique a procedure of first election. In this article it is demonstrated that becomes in costs and hospitable cost reducing to the time of stay competitive and complications derived from the surgical boarding (AU)

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Laparoscopic radical nephrectomy in renal cell carcinoma.

Historically, the only surgical option for removal of a renal mass was through a large incision in the abdomen. Recently, many urologists have adopted new innovations in the removal of renal masses including laparoscopic radical nephrectomy. The laparoscopic approach to radical nephrectomy has been associated with improved patient outcomes including decreased pain, shorter hospital stay, rapid recovery, and improved aesthetic cosmetic appearance. Laparoscopic radical nephrectomy may be performed in three different types of surgical procedures including laparoscopic hand-assisted radical nephrectomy, transperitoneal radical nephrectomy, and retroperitoneal radical nephrectomy. Understanding the procedure, preoperative instructions, and recovery will assist nurses in counseling patients considering laparoscopic radical nephrectomy.

Nephrectomy. A review of the surgical approaches.

Preoperative investigations determine the site, size, extent, and nature of the renal disease, which dictates the type of nephrectomy to be performed. The two basic surgical approaches to the kidney are lateral and anterior, each with its own advantages and disadvantages. Adequate exposure, careful dissection, and individual ligation and division of the renal vessels minimizes the complications with nephrectomy. A chest x-ray on the postanesthesia recovery room will rule out a pneumothorax following nephrectomy.