14 results on '"Patricio García Marchiñena"'
Search Results
2. PD02-02 MULTI INSTITUTIONAL VALIDATION OF A NEW KIDNEY MODEL FOR LAPAROSCOPIC NEPHRON SPARING SURGICAL TRAINING
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Nicolas Bonanno, Santiago Birkner de Miguel, Carlos Ameri, Gonzalo Vitagliano, Matias Biancucci, Leandro Blas, Patricio García Marchiñena, Alberto Jurado, Hernando Rios Pita, Maximiliano Ringa, and Lucas Mey
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medicine.medical_specialty ,Kidney ,medicine.anatomical_structure ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Nephron sparing surgery ,business ,Surgical training ,Nephrectomy ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Laparoscopic partial nephrectomy (LPN) is a very demanding procedure and a large proportion of complications occur during the surgeon's initial learning curve. There is a...
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- 2021
3. Laparoscopic Ureterolysis without Omentoplasty in the Management of the Uropathy Secondary to Idiopathic Retroperitoneal Fibrosis
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Alberto Jurado, Miguel Angel Bergero, Carlos David, Guillermo Gueglio, Patricio García Marchiñena, and Fernando Dipatto
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medicine.medical_specialty ,Uropathy ,business.industry ,medicine ,Surgery ,Ureterolysis ,Idiopathic Retroperitoneal Fibrosis ,medicine.disease ,business - Published
- 2019
4. Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension
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Alberto Jurado, Guillermo Gueglio, Patricio García Marchiñena, and Agustin Romeo
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Pyeloplasty ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Vena Cava, Inferior ,Nephrectomy ,Inferior vena cava ,Renal Veins ,03 medical and health sciences ,Renal Artery ,0302 clinical medicine ,Robotic Surgical Procedures ,Renal cell carcinoma ,Humans ,Medicine ,Neoplasm Invasiveness ,Robotic surgery ,Heart Atria ,Carcinoma, Renal Cell ,Thrombectomy ,Venous Thrombosis ,business.industry ,Prostatectomy ,General Medicine ,medicine.disease ,Embolization, Therapeutic ,Thrombosis ,Kidney Neoplasms ,Surgery ,Review article ,medicine.vein ,030220 oncology & carcinogenesis ,cardiovascular system ,Laparoscopy ,business - Abstract
To review the evidence regarding the current trends in surgical management of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis. Recent published series have shown the role of minimally invasive surgery in IVC thrombectomy. This review article evaluates the present RCC with venous extent literature to assess the role of open and minimally invasive surgery in this scenario. Robotic urological surgery has shown to have known benefits in radical prostatectomy, partial nephrectomy, and pyeloplasty. Recent published series showed feasibility of robotic IVC thrombectomy even for level IV cases. With growing number of robot-assisted and laparoscopic surgeries worldwide, there is a current tendency to treat this complex and challenging pathology with a minimally invasive approach, without compromising oncological outcomes.
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- 2021
5. Bilateral pheochromocytoma after kidney transplantation in neurofibromatosis type 1
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Patricia Fainstein-Day, Andrea Paissan, Alberto Jurado, Mariana Isola, José Alfie, Valeria de Miguel, and Patricio García Marchiñena
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Nephrology ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Normetanephrine ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Pheochromocytoma ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,Medicine ,Neurofibromatosis ,neoplasms ,Kidney transplantation ,Insight into Disease Pathogenesis or Mechanism of Therapy ,lcsh:RC648-665 ,business.industry ,Adrenalectomy ,Metanephrines ,medicine.disease ,Surgery ,Transplantation ,chemistry ,030220 oncology & carcinogenesis ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Summary We present the case of a 25-year-old male with a history of neurofibromatosis type 1 and bilateral pheochromocytoma 4 years after kidney transplantation that was successfully treated with simultaneous bilateral posterior retroperitoneoscopic adrenalectomy. Learning points: Hypertensive patients with NF1 should always be screened for pheochromocytoma. Pheochromocytoma is rarely associated with transplantation, but it must be ruled out in patients with genetic susceptibility. Posterior retroperitoneoscopic adrenalectomy (PRA) allows more direct access to the adrenal glands, especially in patients with previous abdominal surgeries.
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- 2019
6. V09-06 POSTERIOR RETROPERITONEOSCOPIC ADRENALECTOMY: HOW AND WHEN
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Diego Santillan, Ignacio Costabel, Guillermo Gueglio, Agustin Romeo, Patricio García Marchiñena, and Alberto Jurado
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medicine.medical_specialty ,business.industry ,Urology ,Adrenalectomy ,medicine.medical_treatment ,medicine ,business ,Surgery - Published
- 2019
7. American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy
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Mario Alvarez-Maestro, Marcelo Featherston, Oscar Rodriguez Faba, Rene Sotelo, Alberto Jurado Navarro, Oscar Schatloff, Patricio García Marchiñena, Pablo Holst, Luis Martínez-Piñeiro, José Cocisfran Alves Milfont, Ivar Vidal-Mora, Alberto Villaronga, Gustavo Villoldo, J. Rozanec, Juan Ignacio Monzó Gardiner, Hugo Dávila, Octavio A. Castillo, Victor T. Dubeux, Diego Abreu Clavijo, Fernando P. Secin, Ricardo Decia, Stênio de Cássio Zequi, Gustavo Cardoso Guimarães, Anamaria Autran, Andres Hernández-Porrás, Rodrigo Frota, Joan Palou, Humberto Villavicencio Mavric, Félix Santaella-Torres, Luciano A. Nunez Bragayrac, Agustin Rovegno, Diana Finkelstein, R. Sanchez-Salas, and Emilio T. Quesada
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Male ,Nephrology ,Databases, Factual ,medicine.medical_treatment ,Blood Loss, Surgical ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Nephrectomy ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Adenoma, Oxyphilic ,Partial nephrectomy ,Warm Ischemia ,Laparoscopy ,medicine.diagnostic_test ,Margins of Excision ,Kidney cancer ,Middle Aged ,Conversion to Open Surgery ,Kidney Neoplasms ,Tumor Burden ,030220 oncology & carcinogenesis ,Female ,medicine.medical_specialty ,Urology ,Angiomyolipoma ,Operative Time ,03 medical and health sciences ,Internal medicine ,medicine ,Hand-Assisted Laparoscopy ,Humans ,Minimally Invasive Surgical Procedures ,Carcinoma, Renal Cell ,Mexico ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Postoperative complication ,Perioperative ,Length of Stay ,South America ,medicine.disease ,Confidence interval ,Surgery ,Nephron sparing ,Logistic Models ,Spain ,Multivariate Analysis ,business - Abstract
To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan-Meier curves, multivariate logistic and Cox regression analyses. Clavien-Dindo classification was used. We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02-1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3-19; p = 0.02) and females (HR 5.6; 95 % CI 1.7-19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.
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- 2016
8. Renal fossa recurrence after radical nephrectomy: Current management, and oncological outcomes
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Alberto Jurado, Guillermo Gueglio, Patricio García Marchiñena, and Agustin Romeo
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Male ,medicine.medical_specialty ,Fossa ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Renal cell carcinoma ,medicine ,Humans ,Stage (cooking) ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,Kidney ,biology ,business.industry ,Cryoablation ,Middle Aged ,biology.organism_classification ,medicine.disease ,Survival Analysis ,Kidney Neoplasms ,Surgery ,Log-rank test ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Kidney cancers represent 2% of cancers worldwide; the most common type is renal clear cell carcinoma (RCC). Surgical treatment remains the only effective therapy for localized renal cell carcinoma. Approximately 20% to 38% of patients undergoing radical nephrectomy (RN) for localized RCC will have subsequent disease progression, with 0.8% to 3.6% of local recurrences within the ipsilateral retroperitoneum (RFR). The main objective of this study is to evaluate prognostic features, oncological outcomes, and current management for renal fossa recurrence in patients with history of RN for RCC.We retrospectively analyzed 733 patients who underwent open or laparoscopic RN for unilateral T1-T4 N0 M0 RCC between 2010 and 2016 at the Urology Department of Hospital Italiano de Buenos Aires.During the mentioned period, of a total of 733 RNs (open/laparoscopic), 561 patients with RCC were included in the study. After a median follow-up time of 24 months (12-36) (interquartile range), 21 (3.74%) patients out of 561, developed renal fossa recurrence. Of these, 13 (2.31%) patients were diagnosed with isolated local renal fossa recurrence and different treatment approaches were adopted; 11 patients underwent open surgical resection, 1 patient laparoscopic surgical resection, and 1 case was treated with cryoablation. Regarding cancer-specific survival, estimated 4-year cancer-specific survival in patients without RFR, with isolated RFR (iRFR) and not isolated RFR (niRFR) was 82.7% (CI 95% 70.2-95.2), 69.2% (IC 44.2-94.2) and 0%, respectively (log rank test P0.0001 being niRFR group different to others. Non isolated RFR was a death risk factor with a HR of 11.4 (4.8-27.2) compared with iRFR or no recurrence. Overall, 51% (IC 26.6-71.2) of patients with any RFR died at 4 years follow-up.Although RFR is a rare condition, in the absence of distant metastatic disease, aggressive surgical resection should be our aim. High pathological tumoral stage at original nephrectomy and high tumoral grade are independent risk factors for RFR. This group of patients needs closer follow-up to detect earlier recurrences and decide a treatment strategy.
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- 2020
9. V10-07 LAPAROSCOPIC APPROACH FOR VESICOUTERINE FISTULA: STEPPED TECHNIQUE
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Juan Carlos Tejerizo, Gabriel Favre, Patricio García Marchiñena, Agustin Romeo, and Matías Ignacio González
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,business ,Vesicouterine fistula ,Surgery - Published
- 2018
10. V07-08 LAPAROSCOPIC RADICAL NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY
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Diego Santillan, Alberto Jurado, Patricio García-Marchiñena, Miguel Basualdo, and Guillermo Gueglio
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medicine.medical_specialty ,medicine.vein ,business.industry ,Urology ,Medicine ,Laparoscopic radical nephrectomy ,business ,Inferior vena cava ,Surgery - Published
- 2018
11. V6-03 SYNCHRONOUS AND SIMULTANEOUS POSTERIOR REROPERITONEOSCOPIC BILATERAL ADRENALECTOMY
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Miguel Basualdo, Oscar Damia, Alberto Jurado, Guillermo Gueglio, and Patricio García Marchiñena
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Bilateral adrenalectomy ,business ,Surgery - Published
- 2017
12. V11-06 POSTERIOR RETROPERITONEOSCOPIC BILATERAL ADRENALECTOMY IN ECTOPIC CUSHIN'S SYNDROME
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José Ignacio Costabel, Oscar Damia, Jorge Jaunarena, Alberto Jurado Navarro, Guillermo Gueglio, and Patricio García Marchiñena
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medicine.medical_specialty ,S syndrome ,business.industry ,Urology ,medicine ,Bilateral adrenalectomy ,business ,Surgery - Published
- 2016
13. Functional and oncologic outcomes after nephron-sparing surgery in a solitary kidney: 10 years of experience
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Federico Tirapegui, Alberto Jurado, Augusto Dantur, Guillermo Gueglio, José Ignacio Costabel, and Patricio García Marchiñena
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Male ,Fistula ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,lcsh:RC870-923 ,Nephrectomy ,Body Mass Index ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Renal carcinoma ,Postoperative Period ,Warm Ischemia ,Cold Ischemia ,solitary kidney ,Age Factors ,nephron-sparing surgery ,Middle Aged ,Prognosis ,Kidney Neoplasms ,Survival Rate ,030220 oncology & carcinogenesis ,Female ,Original Article ,Glomerular Filtration Rate ,Adult ,medicine.medical_specialty ,partial nephrectomy ,Urology ,Renal function ,Statistics, Nonparametric ,03 medical and health sciences ,medicine ,Carcinoma ,Humans ,Renal Insufficiency, Chronic ,Survival rate ,Carcinoma, Renal Cell ,Dialysis ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Surgery ,business ,Body mass index ,Organ Sparing Treatments - Abstract
Objectives: To evaluate functional and oncologic outcomes of partial nephrectomy (PN) in patients with a solitary kidney. Materials and Methods: A retrospective analysis of patients with a solitary kidney undergoing nephron-sparing surgery between March 2003 and March 2013 was performed. GFR was recorded before the procedure and 3 months after surgery, thus establishing a change (cGFR). Several variables that may influence cGFR were analyzed. Complications are herein described, namely bleeding, fistula, acute renal failure and end-stage renal disease (ESRD). Local recurrence and margin status are also described. Survival rates were calculated using the Kaplan Meier method (2 patients with metastasis at the time of surgery were excluded from the analysis). Results: Forty-five patients were available for analysis. Median follow-up was 27.56 months (r 3-96). Mean cGFR was-7.12mL/min (SD 2.1). Variables significantly related with lower GFR after surgery were loss of renal mass (p=0.01)) and male gender (p=0.03). Four patients (8.8%) experienced hemorrhage. Nine patients (20%) developed a urinary fistula. Only one patient with bleeding required open surgery. Two patients (4.4%) needed transient dialysis. Three patients (6.6%) developed ESRD. Four patients (8.8%) had positive surgical margins (PSMs) and four patients (88%) had local recurrence (2 of these had PSMs). Five patients (11.1%) died during follow-up. Four patients (8.8%) died because of renal cancer. Estimated 2-year overall survival, disease-free survival and cancer specific survival rates were 88.4% (CI 95% 70.5-96); 87.7% (CI 95% 68.1-96) and 92.4% (CI 95% 75-98), respectively. Conclusion: Loss of renal mass and male gender were associated with lower postoperative GFR. Our outcomes were comparable with those in the World literature.
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- 2016
14. Tomografía computada como predictor de composición y fragilidad de la litiasis urinaria al tratamiento con litotricia extracorporea por ondas de choque in vitro
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Francisco Pedro Juan Daels, Juan Cruz Liyo, Mariano Sebastian González, Alberto Jurado, Jorge Ocantos, Patricio García Marchiñena, and Nicolás Billordo Peres
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medicine.medical_specialty ,medicine.diagnostic_test ,Unidades Hounsfield ,business.industry ,Urology ,medicine.medical_treatment ,Urinary Lithiasis ,Litotricia extracorpórea ,Computed tomography ,General Medicine ,Lithotripsy ,Extracorporeal shock wave lithotripsy ,Surgery ,Tomography x ray computed ,X ray computed ,medicine ,Litiasis ,Cristalografía ,Nuclear medicine ,business - Abstract
Objetivo: Desde la aparición de la litotricia extracorpórea por ondas de choque (LEOC), esta se ha convertido en el tratamiento de elección para los cálculos renales menores de 2 cm. La tasa de éxito de la misma varía entre el 60 al 99 % dependiendo de factores tales como la composición, tamaño, tipo de generador, localización, entre otros. El objetivo de este trabajo es evaluar si la densidad del cálculo en unidades Hounsfield (UH) mediante una tomografía computada sin contraste (TCSC) es capaz de predecir composición y fragilidad de la litiasis al tratamiento con LEOC. Métodos: Prospectivamente fueron recolectados 27 litos de alrededor de 10 mm provenientes de pacientes sometidos a diferentes procedimientos endourológicos (19 litotricias percutaneas, 2 litotricias ureterales y 6 litotricias vesicales), los cuales habían sido evaluados tomográficamente, midiéndose en UH la densidad de sus cálculos. Los litos fueron sometidos a litotricia extracorporea por ondas de choque "in vitro", para lo cual se conformó un dispositivo experimental. Se aplicaron 3000 pulsos a una intensidad de 17.2 Kw utilizando un generador electromagnético (Lithostar) a todos los cálculos. Se evaluó la composición de cada uno de los fragmentos mediante un estudio cristalográfico. Los resultados obtenidos fueron analizados estadísticamente utilizando el test de Student, test de Chi² y análisis multivariado. Resultados: La LEOC "in vitro" fue efectiva en 16 casos (59.26 %). Del total de los cálculos estudiados, 11 fueron puros y 16 tuvieron una composición mixta. Las UH promedio de los cálculos, agrupados por composición fue: cistina 1015 UH, oxalato de calcio monohidratados 1193, ácido úrico 419 UH, oxalato de calcio dihidratado 2122 UH , estruvita 1543 UH y fosfato básico de magnesio 1517 UH. Se encontró una relación estadísticamente significativa entre valores menores de 500 UH y composición de ácido úrico (p=0.0006), así como también valores mayores a 2000 UH y composición de oxalato de calcio dihidratado (p=0.0244). En el grupo de cálculos con menos de 1000 UH (n=11) la efectividad fue del 81.8 %, mientras que en el resto fue del 43.75 % (p=0.0479). Al asociar composición del cálculo con efectividad, encontramos una relación estadísticamente significativa entre presencia de ácido úrico y efectividad (p=0.021). No se encontraron relaciones estadísticamente significativas entre tamaño y efectividad del tratamiento. Conclusiones: El uso de la TCSC permitiría predecir la composición de oxalato de calcio dihidratado y ácido úrico. Valores de UH menores a 1000, aumentan significativamente el éxito del tratamiento.
- Published
- 2009
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