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Background Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor that develops from the wall of the IVC and can be confused with many other retroperitoneal tumors. We report the observation of a man with leiomyosarcoma of the vena cava which invades the right kidney. Case presentation 56-year-old man who has seen progress for right back pain for over a year. His thoraco-abdominal-pelvic scanner found a right tumor process measuring 18 × 13 × 18 cm invading the right kidney and the inferior vena cava, heterogeneous in nature, which is enhanced after injection of iodinated contrast product, pushing back the liver and the gall bladder. A border of separation persisted between the mass and the abdominal and thoracic walls. His biological assessment was normal. He underwent an open right nephrectomy with intraoperative bleeding requiring a transfusion of 2 red blood cells. The patient's follow-up period was 8 months without local recurrence or secondary localization. Conclusion The LMS of IVC is a tumor whose management is not yet well codified. Surgery is the only therapeutic means that gives good results, when it is possible. But long-term recurrences remain frequent, which therefore requires prolonged monitoring of these patients.

Resume But Les objectifs de ce travail etaient d’evaluer l’impact de l’examen preoperatoire des urines et du caractere infecte des calculs sur la survenue du sepsis urinaire postoperatoire. Materiel et methodes Une etude prospective monocentrique a inclus 29 patients operes de la lithiase urinaire entre janvier et juin 2018. Resultats Le sepsis urinaire postoperatoire a ete observe chez 4 patients (14 %). Le taux de colonisation urinaire sur l’ECBU preoperatoire etait de 27,6 % (8 sur 29) alors que le taux de calculs colonises etait de 31 % (9 sur 29). La survenue d’un sepsis urinaire a ete constatee chez 37,5 % (3 sur 8) des patients ayant une colonisation urinaire, par rapport a 44,4 % des patients ayant des calculs colonises (4 sur 9). En comparant les resultats bacteriologiques observes lors du sepsis, les germes isoles dans les urines postoperatoires etaient les memes retrouves dans la culture des calculs. La nature chimique des calculs colonises etait principalement l’oxalate de calcium (monohydrate, dihydrate) p = 0,02. Il existe une correlation statistiquement significative entre l’examen preoperatoire d’urine, la culture bacteriologique de calculs et le sepsis urinaire postoperatoire (p = 0,05, p = 0,005) respectivement. Conclusion Notre etude a mis en evidence une forte association entre la culture bacteriologique des calculs et le sepsis urinaire postoperatoire superieure a celle de la culture urinaire preoperatoire. Elle permet d’anticiper la survenue d’une septicemie chez des patients necessitant de nombreux traitements endoscopiques. Cependant, plusieurs series prospectives multicentriques peuvent s’averer necessaires pour valider ces resultats. Niveau de preuve 3.

Day case or same-day discharge (SDD) pure laparoscopic or robot-assisted radical prostatectomy (RP) has risen over the last few years with the aim of discharging patients within 24 h, reducing costs and length of stay, and facilitating return to active life. We perform a systematic review of literature to evaluate the feasibility of SDD RP.A systematic review search was performed and the following bibliographic databases were accessed: PubMed, Science Direct, Scopus, and Embase. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines.Based on the literature search of 509 articles, 12 (1378 patients) met the inclusion criteria (mean age: 63 years). All studies were unicentric except one. The mean SDD surgeries experience per centre was 66 cases .The means operative time and blood loss were 154 min and 126.5 ml, respectively. Mean SDD failure was 7.4%. Concomitant lymph node dissection was performed in 56.2%. The overall complication rate was 10.2% of cases; with a majority of Clavien grade I or II. Mean readmission rate after discharge was 5%. SDD generated cost reductions compared to inpatient surgery with variable differences according to the considered healthcare system.Day-case RP is a safe and feasible strategy in selected cases with multicentre proofs of concept. Its widespread use in routine practice needs further research due to biases in patient selection. Implementation of peri-operative pathways such as ERAS and prehabilitation improves patient adherence to SDD.

Cases of rectal foreign bodies (RFB) insertion are frequently encountred in the last years, leading to many complications, while many patients tends to obscure the context. This entity represent a particular form of rectal injuries that can be more lethal with the peritoneal involvement. However, combination of genitourinary injuries to rectal injuries doesn't worsen the prognosis. We report a case of a RFB injury leading to an extraperitoneal rectal injuri with a recto-vesical fistula that was managed effectively conservatively with successive CT Cystogram follow-ups.

The objectives of this study were to evaluate the impact of preoperative urine culture and the infected nature of stones on the occurrence of postoperative urinary sepsis.A prospective monocentric study included 29 patients operated on for urolithiasis between January and June 2018.Postoperative urinary sepsis was observed in 4 patients (14%). Urinary colonization rate on preoperative CBU exam was 27.6% (8 of 29) while the rate of colonized stones was 31% (9 of 29). The occurrence of urinary sepsis was observed in 37.5% (3 of 8) of patients with urinary colonization, compared to 44.4% of patients with colonized stones (4 of 9). By comparing the bacteriological results observed during sepsis, the germs isolated in postoperative urine were the same found in the culture of stones. The chemical nature of the colonized stones was mainly calcium oxalate (monohydrate, dihydrate) P=0.02. There was a statistically significant correlation between the preoperative urine culture, the bacteriological culture of stones and the postoperative urinary sepsis (P=0.05, P=0.005) respectively.Our study demonstrated a strong association between the bacteriological culture of stones and postoperative urinary sepsis superior to preoperative urine culture. It makes it possible to anticipate the occurrence of sepsis in patients requiring many endoscopic treatments. However, several multicentric prospective series may prove necessary to validate these results.3.