RESUMO
más frecuentes del riñón. Su tratamiento consiste en la exploración quirúrgica y marsupialización. La cirugía laparoscópica permite una mejor disección, exploración e identificación de la anatomía con trauma mínimo del paciente. OBJETIVO. Mostrar la experiencia en el tratamiento quirúrgico laparoscópico mínimamente invasivo del quiste renal simple sintomático. MATERIALES Y MÉTODOS. Estudio retrospectivo del tratamiento laparoscópico transperitoneal, se evaluó la seguridad de la técnica, complicaciones perioperatorias y resultados clínicos en el transcurso de un año. Se estudió 8 pacientes: 4 mujeres y 4 hombres, con diagnóstico de quistes renales simples sintomáticos, atendidos por el Servicio de Urología del Hospital de Especialidades Carlos Andrade Marín de Quito, Ecuador. CASOS CLÍNICOS. Se registró edad, sexo, antecedentes patológicos personales, comorbilidades, historia familiar, examen físico completo, exámenes de imagen y de laboratorio. RESULTADOS. La media de la edad fue de 57 años con un intervalo entre 39 y 77 años. La indicación de cirugía fue dolor en región lumbar ipsilateral, que no respondieron a los analgésicos convencionales. El tamaño de los quistes osciló entre 7-10 cm de diámetro. El tiempo operatorio medio fue de 71 minutos sin requerir conversión a cirugía abierta. Los pacientes fueron dados de alta en los primeros cinco días del postoperatorio y los drenajes extraídos dentro del primer día. CONCLUSIÓN. El tratamiento laparoscópico de quistes renales simples sintomáticos por vía transperitoneal fue exitoso en todos los casos. El abordaje permitió la extirpación de los quistes, con menor morbilidad, y con un mejor confort postoperatorio para los pacientes.
kidney. Its treatment consists of surgical exploration and marsupialization. Laparoscopic surgery allows a better dissection, exploration and identification of the anatomy with minimal patient trauma. OBJECTIVE. To show the experience in the minimally invasive laparoscopic surgical treatment of the symptomatic simple renal cyst. MATERIALS AND METHODS. Retrospective study of transperitoneal laparoscopic treatment, the safety of the technique, perioperative complications and clinical results over the course of a year were evaluated. 8 patients were studied: 4 women and 4 men, with diagnosis of symptomatic simple renal cysts, attended by the Urology Service of the Carlos Andrade Marín Specialty Hospital of Quito, Ecuador. CLINICAL CASES. Age, sex, personal pathological history, comorbidities, family history, complete physical examination, image and laboratory tests were recorded. RESULTS. The mean age was 57 years with an interval between 39 and 77 years. The indication for surgery was pain in the ipsilateral lumbar region, which did not respond to conventional analgesics. The size of the cysts ranged between 7-10 cm in diameter. The mean operative time was 71 minutes without requiring conversion to open surgery. The patients were discharged in the first five days of the postoperative period and the drains extracted within the first day. CONCLUSION. The laparoscopic treatment of simple symptomatic renal cysts by the transperitoneal route was successful in all cases. The approach allowed the removal of the cysts, with less morbidity, and with a better postoperative comfort for the patients.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Período Pós-Operatório , Comorbidade , Laparoscopia , Equinococose , Doenças Renais Císticas , Hipertensão , Equipamentos Cirúrgicos , Terapêutica , CistosRESUMO
A 55-year-old man with no medical history of relevance was referred to our department for chronic back pain. Plain radiographs of the abdomen showed a round calcified image with liquid level inside in the upper-left quadrant. On computed tomography (CT) a bulky solid-cystic mass with calcified wall of 65 × 34 mm was shown in the left adrenal gland with no-contrast enhancement. The patient underwent a laparoscopic approach. Intraoperatively there was a large hard stony mass depending on the left adrenal gland, which was entirely supplanted by the tumor. Complete excision was done. The patient underwent uneventful recovery. Histopathology examination showed a solid-cystic mass with a thick fibrous wall and calcified areas compatible with hydatid cyst. To date there have been published few cases of adrenal hydatid cyst. To our awareness it is the fourth case issued in all literature resected by the laparoscopic approach.
RESUMO
Os autores estudaram o efeito protoescolecida, in vitro e in vivo, de solução salina de cloreto de sódio à concentração de 5,10 e 20%, pela imersão por 24 horas, de fígado e pulmões de ovinos parasitados por cisto hidático. Pelo estudo in vitro os protoescóleces permaneceram viáveis num total de 66,68%, 43,10% e 43,30% quando tratados nas concentrações de 5, 10 e 20%, respectivamente. Pela alimentação de 6 (seis) cães com vísceras assim tratadas, foram encontrados, após a necropsia, 4 (quatro) cães parasitados por Echinococcus. Não houve intolerância nem lesões anátomo-patológicas devido a administração diária de cloreto de sódio nestas concentrações. O tratamento de vísceras por imersão em cloreto de sódio nas concentrações e no tempo descritos não serve como método profilático da equinococose, com vistas a sua utilização na alimentação de cães.
The authors examined the protoescolicide effect of natrium chiorid salty solution, in vitro and in vivo using ovine livers and lungs. The infected organs were immersed in saltysolutions of 5,10 and 20% concentration during 24 hours. By the in vitro experiment, the protoescolices were kept viable in a total 66.68%, 43.10% and 43.30% when treated in a solution of 5.10 and 20%, respectively. The víscera infected with hydatic cyst were offered to 6 dogs. During necropsy 4 of the dogs were found infected whit Echinococcus. Rejection and pathologic lesions could not he related to the daily intake of these vísceras by the dogs. The treatment of vísceras by immersion in natrium chiorid salty solution under the described time and concentration conditions can not be used as a preventive method for equinococosis.
RESUMO
The authors examined the protoescolicide effect of natrium chiorid salty solution, in vitro and in vivo using ovine livers and lungs. The infected organs were immersed in saltysolutions of 5,10 and 20% concentration during 24 hours. By the in vitro experiment, the protoescolices were kept viable in a total 66.68%, 43.10% and 43.30% when treated in a solution of 5.10 and 20%, respectively. The víscera infected with hydatic cyst were offered to 6 dogs. During necropsy 4 of the dogs were found infected whit Echinococcus. Rejection and pathologic lesions could not he related to the daily intake of these vísceras by the dogs. The treatment of vísceras by immersion in natrium chiorid salty solution under the described time and concentration conditions can not be used as a preventive method for equinococosis.
Os autores estudaram o efeito protoescolecida, in vitro e in vivo, de solução salina de cloreto de sódio à concentração de 5,10 e 20%, pela imersão por 24 horas, de fígado e pulmões de ovinos parasitados por cisto hidático. Pelo estudo in vitro os protoescóleces permaneceram viáveis num total de 66,68%, 43,10% e 43,30% quando tratados nas concentrações de 5, 10 e 20%, respectivamente. Pela alimentação de 6 (seis) cães com vísceras assim tratadas, foram encontrados, após a necropsia, 4 (quatro) cães parasitados por Echinococcus. Não houve intolerância nem lesões anátomo-patológicas devido a administração diária de cloreto de sódio nestas concentrações. O tratamento de vísceras por imersão em cloreto de sódio nas concentrações e no tempo descritos não serve como método profilático da equinococose, com vistas a sua utilização na alimentação de cães.
RESUMO
The authors examined the protoescolicide effect of natrium chiorid salty solution, in vitro and in vivo using ovine livers and lungs. The infected organs were immersed in saltysolutions of 5,10 and 20% concentration during 24 hours. By the in vitro experiment, the protoescolices were kept viable in a total 66.68%, 43.10% and 43.30% when treated in a solution of 5.10 and 20%, respectively. The víscera infected with hydatic cyst were offered to 6 dogs. During necropsy 4 of the dogs were found infected whit Echinococcus. Rejection and pathologic lesions could not he related to the daily intake of these vísceras by the dogs. The treatment of vísceras by immersion in natrium chiorid salty solution under the described time and concentration conditions can not be used as a preventive method for equinococosis.
Os autores estudaram o efeito protoescolecida, in vitro e in vivo, de solução salina de cloreto de sódio à concentração de 5,10 e 20%, pela imersão por 24 horas, de fígado e pulmões de ovinos parasitados por cisto hidático. Pelo estudo in vitro os protoescóleces permaneceram viáveis num total de 66,68%, 43,10% e 43,30% quando tratados nas concentrações de 5, 10 e 20%, respectivamente. Pela alimentação de 6 (seis) cães com vísceras assim tratadas, foram encontrados, após a necropsia, 4 (quatro) cães parasitados por Echinococcus. Não houve intolerância nem lesões anátomo-patológicas devido a administração diária de cloreto de sódio nestas concentrações. O tratamento de vísceras por imersão em cloreto de sódio nas concentrações e no tempo descritos não serve como método profilático da equinococose, com vistas a sua utilização na alimentação de cães.