RESUMO
OBJECTIVE: To analyze the perioperatory and short-oncological outcomes in 5 cases with CRPC M0 developed after pRT that underwent salvage laparoscopic RP (sLRP) and review the current evidence. MATERIAL AND METHODS: Perioperatory and oncological outcomes were prospectively analyzed. Inclusion criteria were patients that had received pRT and posteriorly presented with CRPC M0 in standard imagines and positron emission tomography MRI coline. Evidence was reviewed in PUBMED database. RESULTS: No surgical complications and blood transfusion were reported. Two patients required an endoscopic urethrotomy due to bladder neck contracture (Clavien IIIb). Final pathological findings were T3 or more, multifocal with 3 positive surgical margins. Four patients reach undetectable PSA after surgery except one that continuous under ADT without disease progression. After 12 months follow-up, 4 patients persist with undetectable PSA and one with stable disease under ADT. Current evidence demonstrated that CRPC M0 treated with open, laparoscopic or robotic RP a biochemical recurrence of 68.7% as a hormone-sensitive PC; however, 17.4% were disease-free after 4 years of follow-up. CONCLUSION: Our serie, 4 cases are disease free after 12 months follow-up. Current evidence is a retrospective and multicenter experience with few cases and intermediate oncological follow-up. More cases with longer follow-up and better evidence are required to opt for this treatment as a first line.
Assuntos
Neoplasias de Próstata Resistentes à Castração , Neoplasias da Próstata , Hormônios , Humanos , Masculino , Recidiva Local de Neoplasia , Antígeno Prostático Específico , Prostatectomia/métodos , Neoplasias da Próstata/patologia , Neoplasias de Próstata Resistentes à Castração/cirurgia , Estudos Retrospectivos , Terapia de Salvação , Resultado do TratamentoRESUMO
OBJECTIVE: To report 2 cases of an extremely rare bladder tumor such as Cystitis Glandularis (CG) that were management by different strategies and review the current evidence. MATERIAL AND METHODS: Both cases of 43 and 48 years reported the same lower urinary tract symptoms that simulated a malignant bladder tumor. Case 1 presented with an extensive tumor affecting the trigone and the left upper urinary tract; the second case presented a less extensive tumor also at the bladder trigone. RESULTS: The first patient required two bladder tumor resection and a laparoscopic uretero-vesical reimplantation with adyuvant steroids. The other patient only required one bladder tumor resection without adyuvant treatment. Finally, after 7 and 6 months, both patients do not present tumor recurrence; respectively. CONCLUSION: Cystitis Glandularis (CG) represent an extremely rare tumor. Usually presentation is in young people with predilection at the bladder trigone. Current evidence ruled out being preneoplastic without standardized treatment. Two cases were analyzed with completely different characteristics, but with satisfactory treatment.
Assuntos
Cistite , Neoplasias da Bexiga Urinária , Sistema Urinário , Adolescente , Cistite/diagnóstico , Humanos , Recidiva Local de Neoplasia , Bexiga Urinária , Neoplasias da Bexiga Urinária/patologiaRESUMO
Objetivos: El objetivo del estudio fue evaluar nuestra experiencia inicial en cirugía intrarrenal retrógrada para el tratamiento de litiasis renales y determinar si es una cirugía eficaz y segura para realizarse en un centro ambulatorio. Materiales y métodos: Se evaluó a todos los pacientes sometidos a ureterorrenoscopia flexible con láser Holmium en la Clínica Andina de Urología luego de un año de procedimientos. Se determinaron datos demográficos, características de las litiasis operadas, porcentaje libre de litiasis y complicaciones según escala modificada de Clavien. Resultados: Un total de 63 pacientes fueron intervenidos desde marzo de 2017 a marzo de 2018. El tamaño medio de las litiasis urinarias fue de 11,6 mm. En un 93,6% de los pacientes la cirugía se pudo completar sin inconvenientes con un tiempo medio de 44 minutos. El porcentaje global libre de litiasis fue del 76,19%. Un 17,4% tuvo complicaciones generales, sin embargo, solo 2 pacientes requirieron reinternación. Conclusiones: La ureterorrenoscopia flexible es una cirugía mínimamente invasiva, eficaz y segura, con un bajo índice de complicaciones (AU)
Objectives: The aim of this study was to evaluate our initial experience in retrograde intrarenal surgery for the treatment of renal lithiasis and determinate if the surgery is effective and safe to be practice in an ambulatory center. Materials and methods: We recorded all patients who underwent flexible ureterorenoscopy and laser Holmium at Clínica Andina de Urología after one year of surgeries. Demographic information, stones characteristics, stone free rate and complication using Clavien system were gathered. Results: A total of 63 patients underwent flexible ureterorenoscopy from March 2017 to March 2018. Mean stone diameter was 11.6 mm. Surgery was complete in 93.6% of patients with a mean operative time of 44 minutes. Stone free rate was 76.19%. The overall complication rate was 17.4%, nevertheless, only 2 patients were readmitted. Conclusions: IFlexible ureterorenoscopy is a minimally invasive procedure, effective and safe, with a low rate of complications. (AU)
Assuntos
Adulto , Lasers de Estado Sólido/uso terapêutico , Procedimentos Cirúrgicos Minimamente Invasivos , Nefrolitíase/cirurgia , Resultado do Tratamento , Ureteroscopia/métodos , Assistência AmbulatorialRESUMO
Hombre de 47 años de edad, diabético tipo 2, que consulta por cefalea holocraneana de 12 horas de evolución, intensa, que se acompaña de fotofobia. Al examen físico no hay presencia de rigidez de nuca y los signos de Kernig y Brudzinsky son negativos. Se re a l i z óTAC de cráneo sin arrojar resultados positivos. Finalmente, se realizó punción lumbar diagnosticándose meningitisaguda bacteriana.