Search results for "nephrectomy"
showing 10 items of 111 documents
Chromophobe renal cell carcinoma (RCC): oncological outcomes and prognostic factors in a large multicentre series.
2011
Study Type - Outcomes (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? About 80% of RCCs have clear cell histology, and consistent data are available about the clinical and histological characteristics of this histological subtype. Conversely, less attention has been dedicated to the study of non-clear cell renal tumours Specifically, published data show that chromophobe RCC (ChRCC) have often favourable pathological stages and better nuclear grades as well as a lower risk of metastasizing compared with clear cell RCC (ccRCC). Patients with ChRCC were shown to have significantly higher cancer-specific survival (CSS) probabilities compared with ccRCC. H…
Elective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinoma: results of a retrospective, comp…
2012
Study Type - Therapy (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Few studies supported the expanded indications for nephron-sparing surgery (NSS) in selected patients with 4.1 cm renal tumours in the size range (T1b). However, all these comparative studies included both imperative and elective partial nephrectomy and patient selection for analysis was based on pathological stage (pT1) and not on clinical stage (cT1). Patients with clinically organ-confined RCC (cT1) who are candidates for elective PN have a limited risk of clinical understaging. NSS is not associated with an increased risk of recurrence and cancer-specific mortality both in cT1a a…
Expanding spectrum of illness due to community-associated methicillin-resistant Staphylococcus aureus: a case report
2009
Introduction Xanthogranulomatous pyelonephritis is a rarely identified form of chronic pyelonephritis usually caused by gram-negative organisms. Herein, we report the first case caused by infection due to community-associated methicillin-resistant Staphylococcus aureus strain. Case presentation An HIV-infected female with a history of intravenous drug use presented with a three month history of abdominal pain, distension, and fever. Computerized tomography of the abdomen revealed a large multicystic right kidney mass. During surgical exploration an intrarenal abscess was identified. Cultures revealed the presence of community-associated methicillin-resistant Staphylococcus aureus. Histopath…
Mini-laparoscopy, laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery-assisted laparoscopy : novice surgeons’ pe…
2012
Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Over the last few years, minimally invasive urological surgery has evolved towards less invasive, 'scarless' procedures. New surgical concepts, such as those of natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been introduced. Mini-laparoscopy has been rediscovered in an attempt to reduce the invasiveness of standard laparoscopy. This study is the first to compare the perception of surgeons when first facing three different scarless options for performing a porcine nephrectomy and when dealing with the constraints of eac…
Nephrogenic systemic fibrosis--a rapidly progressive disabling disease with limited therapeutic options.
2009
Background Nephrogenic systemic fibrosis (NSF) affects some patients on dialysis after gadolinium contrast agent–enhanced magnetic resonance imaging. It is characterized by progressive skin fibrosis of the extremities, sometimes including the trunk and internal organs. Methods The clinical course of 10 patients with biopsy-proven NSF was analyzed retrospectively with regard to gadolinium exposition, disease onset, and progression of NSF with special emphasis on physical mobility and impact of different therapeutic approaches. Results Despite physiotherapy and different additional therapeutic approaches (eg, immunosuppression, ultraviolet A-1 phototherapy, or extracorporal photopheresis) all…
Small renal tumors: correlation of clinical and pathological features with tumor size.
2007
We analyzed the association between tumor diameter and pathological stage, histological subtype, tumor grade and the incidence of metastases in renal cell carcinoma with a diameter of up to 4 cm (clinical stage T1a).We analyzed a consecutive series of 663 patients with renal tumors 4 cm or less who underwent surgery at our institution between 1990 and 2006. After excluding 115 patients (17.3%) with benign tumors 548 with renal cell carcinoma were included in the study. Tumor size on preoperative imaging was correlated with pathological stage, tumor grade, histological subtype and incidence of metastases at diagnosis. For data analysis tumors were stratified by tumor diameter into 3 groups, …
Nephron sparing surgery for renal cell carcinoma with normal contralateral kidney: 25 years of experience.
2006
We report the long-term results of our consecutive series of 504 patients who underwent NSS for cancer suspicious, solid renal tumors in the presence of a normal opposite kidney at our institution since 1979.A total of 715 patients underwent NSS since 1969, including 504 for an elective indication, that is with a normal opposite kidney. Of these patients 381 (75.6%) had RCC, 123 (24.4%) had cancer suspicious benign lesions, including 53 (10.5%) with oncocytoma, 33 (6.5%) with angiomyo(lipo)ma, 23 (4.6%) with a complicated cyst and 13 (2.8%) with other benign lesions. Of the 381 patients with RCC 283 (74.3%) had clear cell, 68 (17.8%) had papillary and 30 (7.9%) had chromophobic RCC. Mean tu…
Huge isolated port-site recurrence after laparoscopic partial nephrectomy: a case report.
2009
A 66-yr-old man with pain and swelling in the right flank was referred to our clinic for diagnosis. In 2005, the patient underwent a laparoscopic partial nephrectomy for renal cancer of the lower pole of the right kidney. A computed tomography scan revealed a 20-cm tumor in the right abdominal wall, resulting in a suspected diagnosis of port-site metastasis from the first laparoscopic operation. The patient underwent open surgery, which confirmed the diagnosis. After the operation, the patient recovered rapidly.
Renal tumour surgery in elderly patients.
2008
OBJECTIVE To analyse morbidity, renal function and oncological outcome in patients aged ≥80 years who had surgery for renal tumours, as in the elderly such surgery is controversial in relation to life-expectancy and other causes of death. PATIENTS AND METHODS Between 1990 and 2006, in our institution 1625 patients had surgery to treat solid renal tumours suspected to be renal cell carcinoma (RCC); 62 (4%) were aged ≥80 years (mean 82.5), and 73% of these elderly patients had radical nephrectomy (RN) and 27% nephron-sparing surgery (NSS). Results The median (range) follow-up was 3.1 (0.2–14.1) years (89% of the patients). There was no perioperative mortality. There were only minor complicati…
Nephron-sparing surgery for renal cell carcinoma: detailed analysis of complications over a 15-year period.
2005
To assess the incidence of complications of conservative renal surgery for renal cell carcinoma in both elective and imperative indications, and its evolution over a 15 year period.From 1988 to 2003, 127 patients underwent partial nephrectomy or tumorectomy for renal cell carcinoma in our department. INDICATIONs were imperative in 42% (n = 53) and elective in 58% (n=74) of cases. Morbidity was retrospectively assessed according to four parameters: 1- Period of surgery: A, from 1988 to 1999 and B, from 2000 to 2003. 2- INDICATION: elective vs. imperative. 3- experience of surgeon: senior vs. junior. 4- Nature of complications: minor or major. Comparative analysis was conducted using Chi-squa…