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Right Nephrectomy (right + nephrectomy)
Selected AbstractsHand-Assisted Laparoscopic Living-Donor Nephrectomy as an Alternative to Traditional Laparoscopic Living-Donor NephrectomyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2002Joseph F. Buell The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/98,8/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97, 1/00). Mean donor weights were similar (179.6 ± 40.8 vs. 167.4 ± 30.3 lb; p =,NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 ± 9.5 vs. 31.2 ± 7.8 year; p <,0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p <,0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9 ± 0.7 vs. 2.9 ± 0.5 h; p <,0.01) was longer; however, return to diet (6.9 ± 2.8 vs. 25.6 ± 6.1 h; p <,0.01), narcotics requirement (17.9 ± 6.3 vs. 56.3 ± 6.4 h; p <,0.01) and length of stay (51.7 ± 22.2 vs. 129.6 ± 65.7 h; p <,0.01) were less than open donor nephrectomy. Costs were similar ($11 072 vs. 10 840). Graft function and 1-week Cr of 1.4 ± 0.9 vs. 1.6 ± 1.1 g/dL (p =,NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs. [source] Renal cell carcinoma with a huge solitary metastasis to the contralateral adrenal gland: A case reportINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2008Takanobu Utsumi Abstract Renal cell carcinoma (RCC) is capable of metastasizing to several organs. Synchronous isolated contralateral adrenal metastasis of the primary RCC is, however, very rare. Herein we report a case of RCC with a huge solitary metastasis to the contralateral adrenal gland that was surgically treated. We scheduled nephrectomy for the left primary RCC and adrenalectomy for the right adrenal tumor. However, at surgery we found a huge right adrenal tumor that had invaded the right kidney, right renal vein, and inferior vena cava. Therefore right nephrectomy was performed simultaneously with resection and reconstruction of the inferior vena cava. Pathological findings demonstrated that the left renal tumor and right adrenal tumor had the same histology. Although the patient required hemodialysis, he remains well at six months postoperatively. So far, there have been only two cases of a solitary contralateral metastatic adrenal tumor that was larger than the primary RCC, thus the present case is the third one. [source] Intravenous extended liposarcoma arising from renal sinusINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2007Mabumi Matsushita Abstract: Liposarcoma arising from the renal sinus is rare and there have been no reports of intravenous extended liposarcoma of the renal sinus thus far. We report a case of liposarcoma of the renal sinus that extended into the renal venous lumen. A 58-year-old woman was referred to our hospital for an intravascular fatty tumor of the right renal vein incidentally discovered by an abdominal screening ultrasonogram. Computer tomography revealed a fatty tumor extending from the right kidney to the right renal vein with no evidence of metastatic lesions. Total right nephrectomy and extirpation of the intravascular tumor of the right renal vein were carried out. Pathological findings showed well-differentiated liposarcoma of the renal sinus. The tumor invaded to the right renal vein and the renal parenchyma. [source] Metastatic Basal Cell Carcinoma with Neuroendocrine Differentiation or Merkel Cell Carcinoma?JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005A. Andea We present here a case of basal cell carcinoma (BCC) with neuroendocrine features that has transformed into a high-grade neuroendocrine carcinoma with various morphologic features of Merkel cell carcinoma (MCC). A 54-year-old white female was treated for a BCC of the right thigh. Pathologic examination revealed an otherwise classical BCC that demonstrated granular positivity for chromogranin. Six years later the patient developed a right inguinal lymphadenopathy diagnosed as metastatic BCC with squamous changes. The metastatic BCC showed partial peripheral palisading and a trabecular pattern. Two years later the patient underwent a right nephrectomy due to obstruction of the right ureter by metastatic BCC. After another four years the patient came back with extensive involvement of the appendiceal wall and right ovary by a diffusely infiltrating metastatic basaloid and trabecular carcinoma. This time the tumor had many histologic features of MCC and showed strong positivity for chromogranin and also for CK20 and NSE. Electron microscopy revealed neurosecretory granules. This case is an example of a chromogranin positive basal cell carcinoma of the skin, which transformed during multiple recurrences into a high grade neuroendocrine carcinoma with features of Merkel cell tumor, demonstrating the potential for cross differentiation among skin tumors. [source] Thoracic epidural catheters via the caudal and lumbar approaches using styletted multiple port catheters in pediatric patients: a report of three casesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2006B. C. H. Tsui Advancing catheters from the lumbar and caudal epidural spaces to the thoracic level has been reported to be an alternative to the direct thoracic approach. However, as children grow, the threading of catheters in the epidural space becomes increasingly difficult. This report describes three cases of thoracic epidural placement using a multiport catheter threaded from the caudal and lumbar spaces using electrical stimulation guidance. In the first case, a multiport catheter was threaded 22 cm from the lumbar space to T8 following a failed attempt with a single-port catheter in a 9-year-old boy scheduled to undergo a right nephrectomy. In the second case, a multiport catheter was threaded 26 cm from the caudal space to T9 in a 3-year-old girl undergoing fundoplication. In the last case, a multiport catheter was inserted at the completion of a fundoplication in a 2-year-old girl after it had been confirmed that the single-port catheter inserted prior to surgery had not advanced to the desired thoracic level. The multiport catheter was threaded 17 cm without resistance from the caudal space to T9. In all cases, electrical stimulation was used to confirm the location of the catheter tip at the time of insertion. The position of the catheters was later confirmed by X-ray. The multiport catheter incorporates a stylet, which extends to a closed distal tip, within a catheter body that ejects fluid from three lateral holes in a direction perpendicular to the advancing catheter. These properties may facilitate the reliable advancement of catheters in the epidural space. [source] Role of heat shock protein 47 on tubulointerstitium in experimental radiation nephropathyPATHOLOGY INTERNATIONAL, Issue 5-6 2002Diange Liu The molecular mechanisms of fibrosis in radiation nephropathy have received scant attention. Heat shock protein 47 (HSP47), a collagen-binding stress protein, helps in the intracellular processing of procollagen molecules during collagen synthesis. We investigated the role of HSP47 in the progression of radiation nephropathy using experimental radiation nephropathy. Experimental rat groups were as follows: (i) group I, sham operated (n = 12); (ii) group II, single doses of irradiation, either 7, 15 or 25 Gy to left kidney (n = 60); and (iii) group III, a similar irradiation procedure as group II after right nephrectomy (n = 60). The rats were followed up until 9 months after renal exposure to radiation. Renal dysfunction (as determined by serum creatinine and blood urea nitrogen) and hypertension were noted in group III rats, along with inflammatory cell infiltration and interstitial fibrosis (as determined by increased deposition of collagens). Compared to control rat kidneys, an increased expression of HSP47 was noted in kidneys obtained from irradiated rats. By double immunostaining, HSP47-expressing cells were identified as ,-smooth muscle actin-positive myofibroblasts and vimentin-positive tubular epithelial cells. Increased expression of HSP47 was closely associated with increased deposition of collagens in the widened interstitium of irradiated rats. Overexpression of HSP47 by phenotypically altered tubulointerstitial cells might play a role in excessive assembly/synthesis of collagens and could contribute to tubulointerstitial fibrosis in radiation nephropathy. [source] | ||||||||||