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operative salvage for retroperitoneal

Francesco Montorsi, Giorgio Gandaglia, Nicola Fossati, Nazareno Suardi, Cristian Pultrone, Ruben De Groote, Zach Dovey, Paolo Umari, Andrea Gallina, Alberto Briganti, Alexandre Mottrie
BACKGROUND: Salvage lymph node dissection has been described as a feasible treatment for the management of prostate cancer patients with nodal recurrence after primary treatment. OBJECTIVE: To report perioperative, pathologic, and oncologic outcomes of robot-assisted salvage nodal dissection (RASND) in patients with nodal recurrence after radical prostatectomy (RP). DESIGN, SETTING, AND PARTICIPANTS: We retrospectively evaluated 16 patients affected by nodal recurrence following RP documented by positive positron emission tomography/computed tomography scan...
September 3, 2016: European Urology
H Wells, M C Hayes, T O'Brien, S Fowler
OBJECTIVES: To undertake a comprehensive prospective national study of the outcomes of RPLND for testis cancer over a one year period in the United Kingdom. PATIENTS AND METHODS: Data were submitted online using the BAUS Section of Oncology Data and Audit System. All new patients undergoing RPLND for testis cancer between March 2012 and February 2013 were studied prospectively. Data was analysed using Tableau software and case ascertainment compared with Hospital Episode Statistics (HES) data...
June 29, 2016: BJU International
Heather J Chalfin, Wesley Ludwig, Phillip M Pierorazio, Mohamad E Allaf
Patients diagnosed with stage I non-seminomatous germ cell tumor (NSGCT) face the task of selecting a management strategy. Whereas these options all offer excellent survival, unfortunately, each has drawbacks. Retroperitoneal lymph node dissection (RPLND) is a major operation with low, but significant risks of bleeding, chylous ascites, and retrograde ejaculation. Platinum-based chemotherapy is associated with a number of long-term side effects, not all of which are quantified, but include secondary malignancy and early cardiovascular disease...
May 2016: Current Urology Reports
Siamak Daneshmand
PURPOSE: This article aims to critically review the current recommendations with regard to the role of surgery following salvage chemotherapy, growing teratoma syndrome, late relapse, as well as malignant transformation. METHODS: All the literature published in English and available on Pubmed pertaining to refractory germ cell tumors was reviewed and the relevant articles, as well as our own institutional experience were included in this review. RESULTS: There is universal agreement that patients with non-seminoma who have residual tumor measuring greater than one centimeter should undergo post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) for resection of potential teratoma or viable germ cell tumor...
August 2015: Urologic Oncology
Alireza Aminsharifi, Dariush Irani, Ali Eslahi
OBJECTIVES: To describe the management protocol in cases with massive hemorrhage after percutaneous nephrolithotomy (PCNL) with a failed angioembolization or when angioembolization is not available. PATIENTS AND METHODS: Between October 2006 and December 2012, the charts of patients who had undergone PCNL and were complicated with massive post procedural bleeding unresponsive to conservative management were reviewed. Those cases in whom angioembolization had failed, or was unavailable, or could not be afforded by the patient were selected and studied...
2014: International Journal of Surgery
Martin Montenovo, Sandeep Vaidya, Ramasamy Bakthavatsalam, Jeffrey Halldorson
BACKGROUND: Vascular complications, most commonly arterial or venous thrombosis, are one of the most common causes of early graft loss after pancreas transplantation. However, only a few cases of pseudoaneurysm formation have been reported. CASE REPORT: This case report is unique for the presentation of pancreatic graft pseudoaneurysm with a sentinel retroperitoneal bleed as well as the failure to achieve diagnosis by ultrasound or standard cut CT scanning. The case emphasizes the importance of clinical suspicion and the need for dedicated fine-cut CT angiography or standard percutaneous angiography for diagnosis...
2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
R Joshi
BACKGROUND: Retro-peritoneal ureterolithotomy may be first option in impacted large upper and mid ureteric stones in selected cases. METHODS: We performed 16 retroperitoneal laparoscopic ureterolithotomy in a teaching hospital. Out of 16 cases, eleven stones were located in the upper ureter and rest in mid ureter. Main indication was impacted large stone (1.5- 2cm) (1.72 cm, mean size). Failed extracorporeal shock wave lithotripsy and Uretero-renoscopy were other two indications...
September 2013: Journal of Nepal Health Research Council
Amy E Reppert, Omid Jazaeri, Ashok Babu, Joshua I Greenberg, Erica Deluka, Mark R Nehler, Thomas B Reece
BACKGROUND: Endoluminal revascularization has supplanted open techniques for most aortoiliac occlusive disease with open surgery reserved for endovascular failure or long-segment aortoiliac occlusions. A number of clinical and anatomic issues can preclude the use of the infrarenal aorta for inflow. Our approach in these select patients is minimal thoracotomy thoracic bifemoral (mini-TBF) bypass. METHODS: Mini-TBF bypass used a 2-team approach. The cardiac surgery team focused on arterial inflow from the distal descending aorta via a ≤8-cm thoracotomy at ninth interspace...
August 2014: Annals of Vascular Surgery
Paolo Parma, Alessandro Samuelli, Marco Luciano, Bruno Dall'Oglio
OBJECTIVES: We present the video of a laparoscopic correction of a left ureteropelvic junction obstruction in a patient who has already undergone previous surgical open pyeloplasty and subsequent acucise for failure of the first surgery. At 8 years after the second surgery, the patient showed a recurrence of the obstruction of the left ureteropelvic junction.
 It was decided to perform the retroperitoneal laparoscopic correction of the obstruction.
 MATERIALS AND METHODS: With the patient placed in a 90° flank position, 4 trocars are placed in the retroperitoneum space by the Hasson tecnique...
January 2014: Urologia
Salvatore T Scali, Bradley M Schmit, Robert J Feezor, Adam W Beck, Catherine K Chang, Alyson L Waterman, Scott A Berceli, Thomas S Huber
OBJECTIVE: Patients presenting with occluded aortobifemoral (ABF) bypass grafts are managed with a variety of techniques. Redo ABF (rABF) bypass procedures are infrequently performed because of concerns about procedural complexity and morbidity. The purpose of this analysis was to compare midterm results of rABF bypass with those of primary ABF (pABF) bypass for aortoiliac occlusive disease to determine if there are significant differences in outcomes. METHODS: A retrospective review was performed of all patients undergoing ABF bypass for occlusive disease between January 2002 and March 2012...
August 2014: Journal of Vascular Surgery
Jose A Pedrosa, Timothy A Masterson, Kevin R Rice, Richard Bihrle, Stephen D W Beck, Richard S Foster
PURPOSE: While reoperative retroperitoneal lymph node dissection results in durable long-term survival, outcomes are comparatively worse than in patients who undergo initial adequate resection. We identified predictors of cancer specific survival and correlated technical aspects of initial resection to local recurrence in patients treated with repeat retroperitoneal lymph node dissection. MATERIALS AND METHODS: We reviewed subsequent data on 203 patients treated with reoperation for recurrent retroperitoneal germ cell tumor after initial retroperitoneal lymph node dissection with local relapse...
June 2014: Journal of Urology
Jai Prakash, Vishwajeet Singh, Manoj Kumar, Manoj Kumar, Rahul Janak Sinha, Satyanarayan Sankhwar
To compare the retroperitoneoscopic ureterolithotomy (RPLU) versus open mini-incision ureterolithotomy (MIOU) for large and impacted proximal or mid-ureteric stones in prospective randomized manner and to assess the outcome results. In a prospective randomized study between January 2009 and December 2012, 35 RPLU and 35 MIOU were included in the study. The indications for ureterolithotomy were as primary treatment of large and impacted stones more than 1.5 cm in the proximal and mid-ureter and as salvage treatment of failed ureteroscopy (URS)/extracorporeal shock wave lithotripsy (SWL)...
April 2014: Urolithiasis
Cristian Gragnaniello, Kevin A Seex, Lukas G Eisermann, Matthew H Claydon, Gregory M Malham
The authors report on 2 cases of anterior dislocation of the Maverick lumbar disc prosthesis, both occurring in the early postoperative period. These cases developed after experience with more than 50 uneventful cases and were therefore thought to be unrelated to the surgeon's learning curve. No similar complications have been previously reported. The anterior Maverick device has a ball-and-socket design made of cobalt-chromium-molybdenum metal plates covered with hydroxyapatite. The superior and inferior endplates have keels to resist translation forces...
August 2013: Journal of Neurosurgery. Spine
Jan P Goltz, Christian O Ritter, Richard Kellersmann, Detlef Klein, Dietbert Hahn, Ralph Kickuth
PURPOSE: To evaluate efficacy, safety, and midterm patency of a helical, self-expanding nitinol stent after failed percutaneous transluminal angioplasty (PTA) of popliteal artery segments P1 and P2 in patients with chronic critical limb ischemia (CLI) or lifestyle-limiting claudication. METHODS: Between February 2009 and March 2011, 40 patients (23 men; mean age 77±10 years) classified as Rutherford category 3 (n = 10) or 4/5 (n = 30) underwent PTA of the proximal and mid popliteal artery followed by implantation of a SUPERA stent for elastic recoil, residual stenosis, or flow-limiting dissection...
June 2012: Journal of Endovascular Therapy
M Rudert, B M Holzapfel, H Pilge, H Rechl, R Gradinger
OBJECTIVE: Treatment of tumors of the pelvic girdle by resection of part or all of the innominate bone with preservation of the extremity. Implantation and stable fixation using a custom-made megaprosthesis to restore painless joint function and loading capacity. The surgical goal is to obtain a wide surgical margin and local tumor control. INDICATIONS: Primary bone and soft tissue sarcomas, benign or semi-malignant aggressive lesions, metastatic disease (radiation resistance and/or good prognosis)...
July 2012: Operative Orthopädie und Traumatologie
Orhan Gokalp, Ismail Yurekli, Levent Yilik, Serdar Bayrak, Haydar Yasa, Aykut Sahin, Mert Kestelli, Ufuk Yetkin, Ali Gurbuz
BACKGROUND: Both single-graft crossover femoropopliteal (COFP) bypass and crossover femorofemoral plus femoropopliteal bypasses using double grafts may be performed for patients with a medical history of abdominal vascular operations or comorbidity, thereby ineligible for retroperitoneal or transperitoneal approaches. In this study, these two methods were compared. METHODS: A total of 15 patients who were operated on between February 2002 and March 2010 were included and studied retrospectively...
July 2012: Annals of Vascular Surgery
Norman Oneil Machado
CONTEXT: Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to primarily therapeutic procedure. With this, the complexity of the procedure and risk of complication including duodenal perforation have increased. In this article, the recent literature is reviewed to identify the optimal management and factors influencing the clinical outcome. METHOD: Recent literature in English language from the year 2000 onwards, containing major studies of 9 or more cases on duodenal perforation post ERCP were analyzed...
January 2012: JOP: Journal of the Pancreas
Andrea Buffardi, Paolo Destefanis, Beatrice Lillaz, Andrea Bosio, Alessandro Bisconti, Claudia De Maria, Mariateresa Carchedi, Luigi Rolle, Dario Fontana
BACKGROUND: According to the last EAU Guidelines about testicular cancer, surgical resection of residual masses after chemotherapy in NSGCT is indicated in the case of visible residual masses and when serum levels of tumor markers are normal or normalizing. If markers are not normalized and when several chemotherapeutic regimens have failed to cure metastatic disease, resection of residual tumors (so called "desperation surgery") should be offered to these patients. METHODS: We are going to present the case of a 30-year-old patient, affected by metastatic NSGCT...
July 2011: Urologia
Syed Javid Farooq Qadri, Naveed Khan, Muneer Khan
INTRODUCTION: The management of ureteric stones has standardized with the introduction of ureteroscopy (URS), shock wave lithotripsy(SWL) and HO:YAG laser. But still one may need to use laparoscopic ureterolithotomy for failed URS/SWL cases or as a primary procedure for large impacted stones. At centers which do not have access to expensive equipment needed in URS and SWL, laparoscopic ureterolithotomy may be used as a primary procedure. The aim of this article is to share our 10 year long experience and the lessons learnt from performing retroperitoneal laparoscopic ureterolithotomy (RLU) which we believe is the better route than transperitoneal one...
2011: International Journal of Surgery
Thomas WaiThong Ho, Lloyd A Mack, Walley J Temple
BACKGROUND: Retroperitoneal nodal recurrence after curative resection of colorectal cancer is an uncommon and challenging problem. The evidence for salvage surgery is limited and remains controversial, particularly when major vascular structures are involved. Some reports have demonstrated a survival benefit after metachronous resection of retroperitoneal metastasis with and without concomitant aortic resection. We conducted a systematic review of the literature to find evidence in favor of or against salvage surgery...
March 2011: Annals of Surgical Oncology
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