39 results on '"Alonso Y Gregorio, S."'
Search Results
2. Management of distal ureter in laparoscopic nephroureterectomy
- Author
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Alonso y Gregorio, S., Sánchez, S., Monasterio, S., Girón, M., Rando, A., Tabernero, Á., Hidalgo, L., Cisneros, J., and de la Peña, J.J.
- Published
- 2010
- Full Text
- View/download PDF
3. Derivaciones urinarias laparoscópicas
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Alonso y Gregorio, S., Álvarez Maestro, M., Cabrera Castillo, P.M., Tabernero Gómez, A., Cansino Alcaide, R., Cisneros Ledo, J., and De la Peña Barthel, J.J.
- Subjects
Laparoscopia ,Conducto ileal ,Ileal conduit ,Neovejiga ,Derivación urinaria ,Neobladder ,Laparoscopy ,Urinary diversion ,Cistectomía ,Cystectomy - Abstract
Introducción: El tratamiento del cáncer vesical infiltrante y el carcinoma superficial de alto grado recidivante está claramente establecido en la cistectomía radical y linfadenectomía pelviana. Uno de los campos que más dudas plantea en su abordaje por vía laparoscópica es el tratamiento radical del cáncer vesical, que exige experiencia en cirugía laparoscópica pelviana y en el que la derivación urinaria presenta grandes dificultades técnicas a su abordaje laparoscópico. Objetivos: El objetivo fundamental de este artículo es comunicar nuestros resultados con las derivaciones urinarias tras cistectomía radical laparoscópica en las que hemos llevado a cabo las anastomosis ureteroileales por vía laparoscópica. Material y Métodos: Desde enero del 2005 hasta diciembre 2007 hemos completado 67 cistectomías radicales laparoscópicas. Hemos realizado un total de 28 derivaciones urinarias laparoscópicas según nuestra técnica, siendo en 7 pacientes enterocistoplastias de sustitución con una edad media de 54,85 años y en 21 pacientes ureteroileostomía cutánea con una edad media de 69,15 años. Resultados: El tiempo quirúrgico medio de la enterocistoplastia con anastomosis uretral y ureteral laparoscópicas es de 5 h y 30 min. Para la ureteroileostomía cutánea con anastomosis ureteral laparoscópica el tiempo quirúrgico medio ha sido de 4hs. y 30 min. Hemos tenido 1 caso de fuga urinaria en las neovejigas laparoscópicas y 3 casos en los conductos ileales laparoscópicos (14%). No hemos tenido ningún caso de dehiscencia intestinal ni de estenosis ureteroileal. La estancia media de las neovejigas es de 13,6 días para el 85% de los casos y de 11,8 días para el 77,7% de las ureteroileostomías laparoscópicas. Discusión: La cistectomía radical laparoscópica constituye un procedimiento todavía relegado a centros con gran experiencia en cirugía laparoscópica. El procedimiento más aceptado por la mayoría de los grupos incluye realizar la cistectomía por vía laparoscópica y la derivación urinaria por vía abierta. No existen evidencias sobre las posibles ventajas de las derivaciones urinarias por vía laparoscópica. En cualquier caso, son necesarios estudios comparativos para definir claramente el papel de la cirugía laparoscópica en las derivaciones urinarias. Introduction: The treatment of the invasive bladder cancer and the recurrent T1G3 is clearly established in radical cystectomy and pelvic linphadenectomy. One of the fields where the laparoscopic approach implies more doubts is the treatment of bladder cancer, because it requires experience enough in pelvic laparoscopic surgery and the urinary diversion implies great technical difficulties to the laparoscopic approach. Objetives: The main goal of this article is to report our results with the urinary diversion after laparoscopic radical cystectomy where the ureteral anastomosis has been performed by a laparoscopic approach. Methods: From January 2005 to December 2007 we have performed 67 laparoscopic radical cistectomies. We conducted 28 laparoscopic urinary diversions with our technique: 7 neobladder with an average age of 54,85 years and 21 ileal conduit with an average age of 69,15 years. Results: The averagesurgical time for enterocistoplasty with laparoscopic urethral and ureteral anastomosis is of 5 hours and 30 minutes. For the cutaneous ureteroileostomy with laparoscopic ureteral anastomosis the average surgical time has been of 4 hours and 30 minutes. We have had 1 case of urinary leakage in the laparoscopic neobladder and 3 cases in the laparoscopic ileal conduit (14%). We have not intestinal dehiscence nor ileal-ureteric stenosis. The average hospital stay for laparoscopic neobladder is for the 85% of cases of 13,6 days , and of 11,8 days for the 77,7% ofileal ureteric laparoscopies. Discussion: The laparoscopic radical cystectomy is still a procedure reserved for groups with great experience in laparoscopic surgery. Nowadays, the most accepted procedure by most groups includes perform the cystectomy by a laparoscopic approach and the urinary diversion by an open approach. There is no evidence of the advantages of laparoscopic urinary diversion. It is necessary to perform comparative studies to clearly define the role of laparoscopic surgery in the urinary diversion.
- Published
- 2008
4. Infiltración vesical por leucemia linfoblástica aguda: A propósito de un caso y revisión de la literatura
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Martín Hernández,M., Alonso y Gregorio,S., Cansino Alcaide,R., Pérez-Utrilla,M., Aguilera Bazán,A., Regojo Zapata,R., and De la Peña Barthel,J.J.
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Urology ,Vejiga ,Leucemia ,Infiltración ,Hematuria - Abstract
Exponemos el caso de un paciente con infiltración vesical por Leucemia Aguda Linfoblástica. Debido a lo infrecuente de su presentación, revisamos la literatura publicada hasta el momento encontrando 14 casos desde 1932. Aunque excepcional, en un paciente que presenta hematuria de novo o repetida y ha tenido como antecedentes alguna enfermedad hematológica, debemos pensar en la infiltración vesical por la leucemia como posible diagnóstico diferencial.
- Published
- 2008
5. Infiltración vesical por leucemia linfoblástica aguda: A propósito de un caso y revisión de la literatura
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Martín Hernández, M., Alonso y Gregorio, S., Cansino Alcaide, R., Pérez-Utrilla, M., Aguilera Bazán, A., Regojo Zapata, R., and De la Peña Barthel, J.J.
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Leukemia ,Bladder ,Infiltration ,Vejiga ,Leucemia ,Infiltración ,Hematuria - Abstract
Exponemos el caso de un paciente con infiltración vesical por Leucemia Aguda Linfoblástica. Debido a lo infrecuente de su presentación, revisamos la literatura publicada hasta el momento encontrando 14 casos desde 1932. Aunque excepcional, en un paciente que presenta hematuria de novo o repetida y ha tenido como antecedentes alguna enfermedad hematológica, debemos pensar en la infiltración vesical por la leucemia como posible diagnóstico diferencial. We expose you one case of leukemic infiltration of the urinary bladder. This kind of infiltration is rare so we reviewed the literature finding 14 cases since 1932. Although this hematological infiltration is very unusual, it should be considered in patients with leukemia and hematuria.
- Published
- 2008
6. Cirugía renal laparoscópica conservadora de parénquima: Experiencia inicial
- Author
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Aguilera Bazán, A., Alonso y Gregorio, S., Pérez Utrilla, M., Cansino Alcalde, J.R., Cisneros Ledo, J., and De la Peña Barthel, J.
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Laparoscopia ,Laparoscopic ,Nefrectomía parcial ,Nephron sparing surgery ,Tumorectomía ,Partial nephrectomy ,Tumorectomy ,Cirugía conservadora de parénquima - Abstract
Presentamos nuestra experiencia inicial en cirugía renal laparoscópica conservadora de parénquima. Se trata de una cirugía exigente que requiere de una considerable experiencia en cirugía mínimamente invasiva. Esta técnica es particularmente atractiva comparada con la cirugía clásica abierta, debido a la incisión que precisa esta última y a la morbilidad que conlleva. We present our initial experience in laparoscopic nephron sparing surgery. It's a technically advanced procedure requiring considerable minimally invasive expertise. This technique is particularly attractive compared to an open conventional procedure with its larger incision and associated morbidity.
- Published
- 2007
7. Suprarrenalectomía abierta y laparoscópica: Revisión de 10 años
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Aguilera Bazán, A., Pérez Utrilla, M., Alonso y Gregorio, S., Cansino Alcaide, R., Cisneros Ledo, J., and Peña Barthel, J. De la
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Adrenalectomía ,Laparoscopia ,Endocrine surgery ,Feocromocitoma ,Adrenal carcinoma ,Carcinoma suprarrenal ,Adrenalectomy ,Laparoscopy ,Cirugía endocrinológica ,Pheochromocytoma - Abstract
Presentamos los resultados de la revisión de los 10 últimos años de suprarrenalectomías abiertas realizadas en nuestro Servicio, así como el impacto de la suprarrenalectomía laparoscópica introducida en el último año dentro del programa de cirugía laparoscópica retroperitoneal del Hospital Universitario La Paz. La primera adrenalectomía laparoscópica se realizó tras 21 intervenciones retroperitoneales. La experiencia inicial ha sido lo suficientemente buena como para reducir progresivamente las contraindicaciones y aumentar el número de cirugías realizadas con dicha técnica. We present a 10 years open adrenalectomy review in our Service and the beginning of laparoscopic adrenalectomy in the last year as a part of the retroperitoneal laparoscopic program at the Hospital Universitario La Paz . The first laparoscopic adrenalectomy was done after 21 retroperitoneal laparoscopic surgeries. Our initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
- Published
- 2006
8. Cirugía retroperitoneal laparoscópica: experiencia de los 6 primeros meses del Hospital La Paz
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Aguilera Bazán, A., Alonso y Gregorio, S., Cansino Alcaide, R., Hidalgo Togores, L., Cisneros Ledo, J., and Peña Barthel, J. de la
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Laparoscopic nephrectomy ,Curva de aprendizaje ,Laparoscopic complications ,Complicaciones laparoscópicas ,Nefrectomía laparoscópica ,Conversion ,Conversión ,Learning curve - Abstract
Presentamos los resultados iniciales del programa de cirugía laparoscópica retroperitoneal del Hospital Universitario La Paz desde julio de 2004 hasta diciembre de 2004. El programa se inició tras 2 años de experiencia en cirugía laparoscópica pélvica. La experiencia inicial ha sido lo suficientemente buena como para reducir progresivamente las contraindicaciones y aumentar el número de cirugías realizadas con dicha técnica. We present the initial results of retroperitoneal laparoscopic surgery in the Hospital Universitario La Paz from july 2004 to december 2004. The program started after 2 years of pelvic laparoscopy surgery practice. The initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
- Published
- 2005
9. Uso del gel de lidocaína intrarectal en las biopsias transrectales ecodirigidas de próstata
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García Mediero, J.M., Martínez-Piñeiro Lorenzo, L., Núñez Mora, C., Ramón de Fata Chillón, F., Cruz Jimeno, J.L., Alonso y Gregorio, S., and Peña Barthel, J.J. de la
- Subjects
Intrarectal lidocaine ,Biopsias próstata ,Pain ,Lidocaína intrarectal ,Dolor ,Prostate biopsies - Abstract
OBJETIVO: Valoramos de una manera cuantitativa el grado de molestias y dolor de las biopsias y evaluamos la eficacia del gel de lidocaína intrarectal. MÉTODO: Realizamos un total de 140 biopsias transrectales de próstata ecodirigidas (BTPE) por sospecha de adenocarcinoma prostático. Los pacientes fueron incluidos de forma aleatoria y homogénea en dos brazos, uno recibió gel de lidocaína, 20 mg (Xylocaina®), intrarectal (grupo 1, n = 71) y el otro placebo, lubricante sin anestesia, (grupo 2, n = 28), diez minutos antes del procedimiento. RESULTADOS: La mediana global de dolor fue de 3,7 (0 no dolor y 10 máximo de dolor) y de molestias de 3,5. Los pacientes del grupo 1 (Xylocaína®) mostraron una tendencia a presentar menos dolor y molestias aunque no alcanzó el grado de significación deseado (p = 0,7 y p = 0,5, respectivamente). CONCLUSIONES: En nuestro medio no obtenemos los resultados descritos por otros grupos en cuanto a la disminución del dolor con el uso de gel intrarectal de anestesia tópica. No hemos encontrado diferencias significativas en cuanto a nivel de PSA, biopsias previas realizadas, uso del gel de lidocaína y grado de información recibida que afecten al grado de molestias y dolor. OBJECTIVE: To know in a quantitative manner the degree of discomfort and pain of the biopsies of the prostate and to evaluate the effectiveness of the transrectal lidocaine. MATERIAL AND METHOD: We performed 140 transrectal biopsies of the prostate. Patients were included on a random basis into two arms: one of them received intrarectal lidocaine, 20 mg (group 1, n = 71) and the other group received placebo (group 2, n = 28) both of them ten minutes prior the proceeding. RESULTS: The global pain mean was 3.7 (0 no pain, 10 highest pain) and the global discomfort mean was 3.5. The group 1 patients showed a trend to feel less pain and discomfort although it did not reach the necessary statistic significance (p = 0,7 y p = 0,5 respectively). CONCLUSIONS: We do not achieve the good results obtained by other groups in order to decrease the degree of pain and discomfort with the use of intrarectal lidocaine. We did not find relationship between the PSA level, previous biopsies, intrarectal lidocaina and degree of information received and the degree of pain and discomfort.
- Published
- 2003
10. 556 Iatrogenic ureteral stricture: Laparoscopic ureteral reimplantation
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Gómez, Rivas J., primary, Alonso, Y Gregorio S., additional, López, Sánchez D., additional, Pons, Viver J., additional, Tabernero, Gómez A., additional, Cisneros, Ledo J., additional, and De La Peña, Barthel J.J, additional
- Published
- 2013
- Full Text
- View/download PDF
11. 1036 Laparoscopic radical cystectomy with prostate capsule sparing. Oncologic and functional results: Our experience
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Gómez, Rivas J., primary, Alonso Y Gregorio, S., additional, López, Sánchez D., additional, Tabernero, Gómez A., additional, Cisneros, Ledo J., additional, and De La Peña Barthel, J.J., additional
- Published
- 2013
- Full Text
- View/download PDF
12. Abordaje del uréter distal en la nefroureterectomía laparoscópica
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Alonso y Gregorio, S., primary, Sánchez, S., additional, Monasterio, S., additional, Girón, M., additional, Rando, A., additional, Tabernero, Á., additional, Hidalgo, L., additional, Cisneros, J., additional, and de la Peña, J.J., additional
- Published
- 2010
- Full Text
- View/download PDF
13. Derivaciones urinarias laparoscópicas
- Author
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Alonso y Gregorio, S., primary, Álvarez Maestro, M., additional, Cabrera Castillo, P.M., additional, Tabernero Gómez, A., additional, Cansino Alcaide, R., additional, Cisneros Ledo, J., additional, and De la Peña Barthel, J.J., additional
- Published
- 2008
- Full Text
- View/download PDF
14. Cirugía renal laparoscópica conservadora de parénquima: Experiencia inicial
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Aguilera Bazán, A., primary, Alonso y Gregorio, S., additional, Pérez Utrilla, M., additional, Cansino Alcalde, J.R., additional, Cisneros Ledo, J., additional, and De la Peña Barthel, J., additional
- Published
- 2007
- Full Text
- View/download PDF
15. Suprarrenalectomía abierta y laparoscópica: Revisión de 10 años
- Author
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Aguilera Bazán, A., primary, Pérez Utrilla, M., additional, Alonso y Gregorio, S., additional, Cansino Alcaide, R., additional, Cisneros Ledo, J., additional, and Peña Barthel, J. De la, additional
- Published
- 2006
- Full Text
- View/download PDF
16. Cirugía retroperitoneal laparoscópica: experiencia de los 6 primeros meses del Hospital La Paz
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Aguilera Bazán, A., primary, Alonso y Gregorio, S., additional, Cansino Alcaide, R., additional, Hidalgo Togores, L., additional, Cisneros Ledo, J., additional, and Peña Barthel, J. de la, additional
- Published
- 2005
- Full Text
- View/download PDF
17. Uso del gel de lidocaína intrarectal en las biopsias transrectales ecodirigidas de próstata
- Author
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García Mediero, J.M., primary, Martínez-Piñeiro Lorenzo, L., additional, Núñez Mora, C., additional, Ramón de Fata Chillón, F., additional, Cruz Jimeno, J.L., additional, Alonso y Gregorio, S., additional, and Peña Barthel, J.J. de la, additional
- Published
- 2003
- Full Text
- View/download PDF
18. Laparoscopic donor nephrectomy versus open donor nephrectomy: Outcomes from a single transplant center
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Dm, Carrión, Gómez Rivas J, Aguilera Bazán A, Alonso Y Gregorio S, De Castro Guerín C, Mario Álvarez-Maestro, Díez Sebastián J, Aguilar A, Jimenez C, and Martínez-Piñeiro L
19. Laparoscopic donor nephrectomy versus open donor nephrectomy: Outcomes from a single transplant center
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Carrión, D. M., Rivas, J. G., Bazán, A. A., Alonso Y Gregorio, S., Castro Guerín, C., Mario Álvarez-Maestro, Sebastián, J. D., Aguilar, A., Jimenez, C., Gómez, Á T., Cansino, R., Alonso Dorrego, J. M., and Martínez-Piñeiro, L.
20. 1036 Laparoscopic radical cystectomy with prostate capsule sparing. Oncologic and functional results: Our experience.
- Author
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G, Rivas J., Alonso Y Gregorio, S., L, S, Tabernero, G, Cisneros, Ledo J., and De La Pe, J.J.
- Published
- 2013
- Full Text
- View/download PDF
21. 556 Iatrogenic ureteral stricture: Laparoscopic ureteral reimplantation.
- Author
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G, Rivas J., Alonso, Y Gregorio S., L, S, Pons, Viver J., Tabernero, G, Cisneros, Ledo J., and De La Pe, Barthel J.J
- Published
- 2013
- Full Text
- View/download PDF
22. Laparoscopic donor nephrectomy versus open donor nephrectomy: Outcomes from a single transplant center.
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Carrión DM, Gómez Rivas J, Aguilera Bazán A, Alonso Y Gregorio S, De Castro Guerín C, Álvarez-Maestro M, Díez Sebastián J, Aguilar A, Jimenez C, Gómez Tabernero Á, Cansino R, Alonso Dorrego JM, and Martínez-Piñeiro L
- Subjects
- Humans, Retrospective Studies, Tissue and Organ Harvesting, Kidney Transplantation, Laparoscopy, Living Donors, Nephrectomy
- Abstract
Objectives: Laparoscopic donor nephrectomy (LDN) is currently replacing open donor nephrectomy (ODN) across the world. Its advantages in terms of patient recovery are well known. We sought to compare surgical outcomes, particularly renal function during the post-nephrectomy period, for renal grafts procured by LDN versus ODN in our center. METHODS: We retrospectively analyzed all cases of living donor nephrectomies performed from 2004 to 2014 at Hospital Universitario La Paz. We compared demographic data; medical background, operative times, post-operative complications, and renal function follow up at 6, 12 and 18-month controls. RESULTS: A total of 114 living donor nephrectomies were performed: 85 LDN and 29 ODN. Demographic characteristics and medical background were similar among both groups, except mean donor age; 41.4 vs 47.4 years (p = 0.009) in the LDN and ODN groups respectively. LDN was used predominantly for left kidneys (83 out of 85), and ODN for right kidneys (28 out of 29). Although not significantly, mean operative time was shorter for the LDN group (169.37 vs 181.46 minutes; p = 0.2). Mean warm ischemia time was shorter for the ODN group (2.92 vs 2.36 minutes; p = 0.28). Differences between post-operative complications were not statistically different between both groups (p = 0.19). There were no conversions from LDN to ODN, and no re-admissions were registered. Length of stay was slightly shorter in LDN but not different (4.29 vs 4.92 days; p = 0.43). Renal function follow-up, measured with serum creatinine levels showed no difference over time (p = 0.67). CONCLUSIONS: Data from our series demonstrate that outcomes and renal function follow up over time were similar among both groups. In expert hands, this altruistic procedure can be performed with a minimally invasive approach without an increased complication rate or compromising renal function in donors.
- Published
- 2019
23. A novel heterozygous mutation in the Birt-Hogg-Dubé Syndrome.
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Gómez Rivas J, Carrión DM, Alonso Y Gregorio S, Álvarez-Maestro M, Tabernero Gómez Á, and Cisneros Ledo J
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- Aged, Heterozygote, Humans, Male, Birt-Hogg-Dube Syndrome genetics, Carcinoma, Renal Cell genetics, Kidney Neoplasms genetics, Mutation
- Abstract
Objetive: Our aim is to present a novel mutation of the Birt-Hogg-Dubé Syndrome., Methods: We present a case report of a 70-year-old male with three solid nodulary lesions of 4, 2.6, and 3 cm each in the right kidney, and two lesions of 1.5 and 1.3 cm in the left kidney., Results: Needle biopsy was performed. The pathological analysis of right kidney lesions revealed a renal tumor suggestive of chromophobe renal cell carcinoma and medullar tumor with zones that suggested oncocytosis. Genetic test results were positive for a novel heterozygous mutation c.1198G>A; p.V400I in exon 11 of the FLCN gene., Conclusion: In patients presenting with bilateral multifocal renal tumors of oncocytic hybrid histology, Birt- Hogg-Dubé syndrome should be the first diagnosis in mind. The mutation found in this patient has not been previously described in the literature in the context of BHD.
- Published
- 2017
24. Human native Ca v 1 channels in chromaffin cells: contribution to exocytosis and firing of spontaneous action potentials.
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Hernández-Vivanco A, Sanz-Lázaro S, Jiménez-Pompa A, García-Magro N, Carmona-Hidalgo B, Pérez-Alvarez A, Caba-González JC, Tabernero A, Alonso Y Gregorio S, Passas J, Blázquez J, González-Enguita C, de Castro-Guerín C, and Albillos A
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- Calcium metabolism, Chromaffin Cells drug effects, Humans, Isradipine pharmacology, Nifedipine pharmacology, Action Potentials drug effects, Caveolin 1 metabolism, Chromaffin Cells cytology, Chromaffin Cells metabolism, Exocytosis drug effects
- Abstract
The present study was performed to evaluate the Ca
v 1 channel subtypes expressed in human chromaffin cells and the role that these channels play in exocytosis and cell excitability. Here we show that human chromaffin cells obtained from organ donors express Cav 1.2 and Cav 1.3 subtypes using molecular and pharmacological techniques. Immunocytochemical data demonstrated the presence of Cav 1.2 and Cav 1.3 subtypes, but not Cav 1.1 or Cav 1.4. Electrophysiological experiments were conducted to investigate the contribution of Cav 1 channels to the exocytotic process and cell excitability. Cav 1 channels contribute to the exocytosis of secretory vesicles, evidenced by the block of 3μM nifedipine (36.5±2%) of membrane capacitance increment elicited by 200ms depolarizing pulses. These channels show a minor contribution to the initiation of spontaneous action potential firing, as shown by the 2.5 pA of current at the threshold potential (-34mV), which elicits 10.4mV of potential increment. In addition, we found that only 8% of human chromaffin cells exhibit spontaneous action potentials. These data offer novel information regarding human chromaffin cells and the role of human native Cav 1 channels in exocytosis and cell excitability., (Copyright © 2016 Elsevier B.V. All rights reserved.)- Published
- 2017
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25. Approach to kidney stones associated with ureteropelvic junction obstruction during laparoscopic pyeloplasty.
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Rivas JG, Alonso Y Gregorio S, Sánchez LC, Guerin Cde C, Gómez AT, Togores LH, and Barthel JJ
- Abstract
Introduction: We have performed laparoscopic pyeloplasty (LP) in our department since 2004. Our goal is to describe, step by step, the approach of kidney stones during transperitoneal laparoscopic pyeloplasty and the outcomes after the procedure., Material and Methods: Twelve patients with kidney stones treated by transperitoneal laparoscopic pyeloplasty were found. The hospital records with clinical features, supplementary tests, and imaging studies were reviewed for demographic, procedural, and efficacy data., Results: Kidney stones were found in 12 of 62 patients (19%) who had undergone transperitoneal laparoscopic pyeloplasty. Eight cases were treated using a flexible cystoscope and a nitinol N-Circle basket; in the remaining four cases the stones were extracted using laparoscopic grasping instruments. We want to emphasize a case of horseshoe kidney associated with ureteropelvic junction (UPJ) obstruction and a kidney stone in which the procedure was performed successfully., Conclusions: Laparoscopic pyeloplasty has now emerged as a standard approach to UPJ obstruction. Associated renal abnormalities or kidney stones add complexity to the procedure, however, as shown in our results, centers with experience in the laparoscopic approach of reconstructive urology make this technique feasible.
- Published
- 2014
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26. Pharmacological characterization of native α7 nicotinic ACh receptors and their contribution to depolarization-elicited exocytosis in human chromaffin cells.
- Author
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Pérez-Alvarez A, Hernández-Vivanco A, Alonso Y Gregorio S, Tabernero A, McIntosh JM, and Albillos A
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- Acetylcholine pharmacology, Aconitine analogs & derivatives, Aconitine pharmacology, Adolescent, Adult, Aged, Bungarotoxins pharmacology, Cell Membrane drug effects, Cell Membrane physiology, Cells, Cultured, Chromaffin Cells drug effects, Exocytosis drug effects, Female, Humans, Male, Middle Aged, Nicotinic Agonists pharmacology, Nicotinic Antagonists pharmacology, Patch-Clamp Techniques, Secretory Vesicles drug effects, Secretory Vesicles physiology, Young Adult, alpha7 Nicotinic Acetylcholine Receptor, Chromaffin Cells physiology, Exocytosis physiology, Receptors, Nicotinic physiology
- Abstract
Background and Purpose: Expression of α7 nicotinic acetylcholine receptors (nAChRs) and their role in exocytosis have not yet been examined in human chromaffin cells., Experimental Approach: To characterize these receptors and investigate their function, patch-clamp experiments were performed in human chromaffin cells from organ donors., Key Results: The nicotinic current provoked by 300µM ACh in voltage-clamped cells was blocked by the nicotinic receptor antagonists α-bungarotoxin (α-Bgtx; 1µM; 6 ± 1.7%) or methyllycaconitine (MLA; 10nM; 7 ± 1.6%), respectively, in an irreversible and reversible manner, without affecting exocytosis. Choline (10mM) pulses induced a biphasic current with an initial quickly activated (5.5 ± 0.4ms rise time) and inactivated component (8.5 ± 0.4ms time constant) (termed α7), which was blocked by α-Bgtx or MLA, followed by a slower component (non-α7). α7 nAChR currents were dissected by blocking the non-α7 nAChR current component of the ACh and choline response with the α6* nAChR blocker α-conotoxin (α-Ctx) MII[S4A, E11A, L15A]. PNU-282987, an α7 nAChR-specific agonist, elicited rapidly activated and rapidly inactivated currents. α7 nAChR-positive allosteric modulators, such as 5-hydroxyindole (1mM) and PNU-120596 (10µM), potentiated responses that were blocked by α-Bgtx or MLA. Exocytosis was evoked by depolarization-elicited α7 nAChR currents, using choline in the presence of α-Ctx MII[MS4A, E11A, L15A] or PNU-282987 as agonists., Conclusions and Implications: Our electrophysiological recordings of pure α7 nAChR currents elicited by rapid application of agonists demonstrated that functional α7 nAChRs are expressed and contribute to depolarization-elicited exocytosis in human chromaffin cells., (© 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.)
- Published
- 2012
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27. Laparoscopic transperitoneal radical prostatectomy in renal transplant recipients: a review of the literature.
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Maestro MA, Gómez AT, Alonso Y Gregorio S, Ledo JC, de la Peña Barthel J, and Martínez-Piñeiro L
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- Feasibility Studies, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Kidney Transplantation, Laparoscopy, Prostatectomy methods, Prostatic Neoplasms surgery
- Abstract
Objectives: To report our experience with laparoscopic radical prostatectomy (LRP) for the treatment of localized prostate carcinoma in two renal transplant recipients and a review of the literature., Patients and Methods: We retrospectively identified all patients who had undergone LRP for clinically localized prostate cancer between 2002 and 2008 at our institution (n = 1150). Of these patients, two were renal transplant recipients (one with donor renal transplant cadaver and the other with prior transplantectomy). We reviewed all available clinicopathological data and the scientific literature., Results: The two patients underwent successful LRP with no major complications. The mean (range) operative time was 200 (180-220) min with a mean estimated blood loss of 300 (200-400) mL. There were no changes in renal graft function as measured by serum creatinine level. At pathology, the surgical margins were negative and disease was organ-confined in each case. The two patients tolerated the procedure well and had a mean (range) hospital stay of 3.5 (3-4) days., Conclusions: The data from our two patients suggest that LRP, as an accepted minimally invasive treatment for a middle-aged man with organ-confined prostate cancer, is a technically feasible and safe treatment of localized prostate cancer in renal transplant recipients.
- Published
- 2010
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28. Laparoscopic repair of the vesicovaginal fistula (laparoscopic O'Connor repair).
- Author
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Alonso y Gregorio S, Alvarez Maestro M, Cabrera Castillo PM, Hidalgo Togores L, and de la Peña Barthel JJ
- Subjects
- Female, Humans, Middle Aged, Urologic Surgical Procedures methods, Laparoscopy, Vesicovaginal Fistula surgery
- Abstract
Introduction: The most frequent cause of vesicovaginal fistula in developed countries is hysterectomy, while in the third world it is related to time in labour. Any surgical iatrogenic trauma implies encountering added difficulties of various kinds when repairing the condition., Material and Method: We report the first case of vesicovaginal fistula to be resolved laparoscopically in our department. The patient is a woman 50 years of age who had undergone an abdominal hysterectomy 8 months previously, and who presented a syndrome compatible with vesicovaginal fistula. She was referred to our division after an unsuccessful attempt at vaginal repair. We will now describe the laparoscopic vesicovaginal fistula repair procedure., Results: The surgical procedure lasted approximately 3 hours and 30 minutes. The patient began oral intake 48 hours after surgery, normal intestinal transit was restored by the 5th day, a cystography was performed on the 7th day, and the patient was discharged on the 8th day. The patient remains asymptomatic after more than a year and a half., Conclusions: Laparoscopic resolution of vesicovaginal fistula is perfectly feasible and safe. If we consistently reproduce the principles applied in the open surgery, it offers the same success rate with the lowest possible morbidity.
- Published
- 2009
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29. [Laparoscopic radical nephrectomy in big surgical specimens].
- Author
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Alonso y Gregorio S, Sánchez S, Soler C, Rando A, Girón M, Tabernero Gómez AJ, Aguilera A, Cisneros Ledo J, and de la Peña Barthel J
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Kidney Neoplasms pathology, Kidney Neoplasms surgery, Laparoscopy, Nephrectomy methods
- Abstract
Introduction: The retroperitoneal surgery is the clearer indication for the laparoscopic approach. Still there are indications for open surgery because of the complexity of the patient and the surgeon experience., Objectives: The main objective is to report our experience of laparoscopic radical nephrectomies in patient with tumors greater than 7 cm. or surgical specimens with more than 700 g of weight. We analyze their characteristics, complications rate, surgical time, postoperative outcome and hospital stay., Materials and Methods: Since July 2004 to July 2008 we have performed 104 laparoscopic radical nephrectomies. We have selected 41 patients with characteristics of big surgical specimens., Results: The average surgical time has been of 184,3 min. Only 1 case has been converted into open surgery and only 1 intraoperative death because of cardiologic arrhythmia. The average hospital stay has been of 3,51 days. The complications rate and postoperative outcome are similar to the whole series., Discussion: Laparoscopic nephrectomy is technically less complex than radical prostatectomy. However, their possible complication implies a much bigger severity. The more complex cases must be approach laparoscopically only after a wide experience. Actually, in our department we usually indicate an open approach when surgical specimen crossover the abdominal middle line and in those cases where the tumoral thrombus affect the main renal vein and/or the vena cava.
- Published
- 2009
- Full Text
- View/download PDF
30. [Laparoscopic urinary diversions].
- Author
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Alonso y Gregorio S, Alvarez Maestro M, Cabrera Castillo PM, Tabernero Gómez A, Cansino Alcaide R, Cisneros Ledo J, and De la Peña Barthel JJ
- Subjects
- Aged, Female, Humans, Ileum surgery, Male, Middle Aged, Cystectomy methods, Laparoscopy, Urinary Bladder Neoplasms surgery, Urinary Diversion methods
- Abstract
Introduction: The treatment of the invasive bladder cancer and the recurrent T1G3 is clearly established in radical cystectomy and pelvic linphadenectomy. One of the fields where the laparoscopic approach implies more doubts is the treatment of bladder cancer, because it requires experience enough in pelvic laparoscopic surgery and the urinary diversion implies great technical difficulties to the laparoscopic approach., Objectives: The main goal of this article is to report our results with the urinary diversion after laparoscopic radical cystectomy where the ureteral anastomosis has been performed by a laparoscopic approach., Methods: From January 2005 to December 2007 we have performed 67 laparoscopic radical cistectomies. We conducted 28 laparoscopic urinary diversions with our technique: 7 neobladder with an average age of 54, 85 years and 21 ileal conduit with an average age of 69, 15 years., Results: The averagesurgical time for enterocistoplasty with laparoscopic urethral and ureteral anastomosis is of 5 hours and 30 minutes. For the cutaneous ureteroileostomy with laparoscopic ureteral anastomosis the average surgical time has been of 4 hours and 30 minutes. We have had 1 case of urinary leakage in the laparoscopic neobladder and 3 cases in the laparoscopic ileal conduit (14%). We have not intestinal dehiscence nor ileal-ureteric stenosis. The average hospital stay for laparoscopic neobladder is for the 85% of cases of 13.6 days, and of 11.8 days for the 77.7% of ileal ureteric laparoscopies., Discussion: The laparoscopic radical cystectomy is still a procedure reserved for groups with great experience in laparoscopic surgery. Nowadays, the most accepted procedure by most groups includes perform the cystectomy by a laparoscopic approach and the urinary diversion by an open approach. There is no evidence of the advantages of laparoscopic urinary diversion. It is necessary to perform comparative studies to clearly define the role of laparoscopic surgery in the urinary diversion.
- Published
- 2008
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31. Impact of a clinical pathway in patient care following surgery on laparoscopic radical prostatectomy.
- Author
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Parrado CL, Alonso y Gregorio S, Martín-Martínez A, Martín-Vega A, Caballero JG, and Barthel JJ
- Subjects
- Aged, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Postoperative Care, Spain, Critical Pathways, Laparoscopy, Prostatectomy methods
- Abstract
Purpose: The aim of this study was to evaluate the impact of clinical pathway (CP) implementation in laparoscopic radical prostatectomy (LRP) has had on patient care and clinical evolution after discharge., Materials and Methods: Eighty-six patients were included in 2 groups: first group was composed of patients operated since the new technique (LRP) was used until the CP was implemented (26 patients operated in 2002) and, second group, with 60 patients, followed the CP during 2004 and 2005., Results: The operative time was reduced from 377.7 to 172.3 minutes after the CP implementation. The duration of bladder catheterization decreased by more than 10 days (from 26.17 to 15.85 days) and that of thromboprophylaxis was reduced from 6.44 to 3.38 days. No difference was found in the rate of complications in the first month after surgery, nor was there any difference in the rate of occurrence of erectile dysfunction, incontinence, and biochemical recurrence during the first year after surgery., Conclusion: After the implementation of the CP, there have been better results in patient care, such as reduction in the duration of catheterization and thromboprophylaxis. In comparison with other studies, we observed a clear reduction in length of stay and operative time. However, there is still room for improvement in reducing the duration of catheterization.
- Published
- 2008
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32. [Leukemic infiltration of the urinary bladder. A new case and literature review].
- Author
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Martín Hernández M, Alonso y Gregorio S, Cansino Alcaide R, Pérez-Utrilla M, Aguilera Bazán A, Regojo Zapata R, and De la Peña Barthel JJ
- Subjects
- Aged, Female, Humans, Leukemic Infiltration, Urinary Bladder pathology
- Abstract
We expose you one case of leukemic infiltration of the urinary bladder. This kind of infiltration is rare so we reviewed the literature finding 14 cases since 1932. Although this hematological infiltration is very unusual, it should be considered in patients with leukemia and hematuria.
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- 2008
- Full Text
- View/download PDF
33. [Laparoscopic nephroureterectomy: new position for the management of distal ureter].
- Author
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Aguilera Bazán A, Alonso y Gregorio S, Pérez Utrilla M, Cansino Alcaide R, Cisneros Ledo J, and De la Peña J
- Subjects
- Aged, Female, Humans, Male, Posture, Laparoscopy, Nephrectomy methods, Ureter surgery
- Abstract
Objectives: The main challenge of laparoscopic nephroureterectomy is the management of distal ureter, which also will have an important repercussion in the oncological outcome of many cases. We present our experience in such aspect, considering that we performed the last five laparoscopic nephroureterectomies in forced Trendelemburg position, resulting in a more comfortable and safe management of the distal ureter., Methods: Between August and December 2006 we performed five purely laparoscopic nephroureterectomies with bladder cuff positioning the patient in forced Trendelemburg, a position similar to that of laparoscopic radical cystectomy or prostatectomy., Results: Mean surgical time was 182 minutes (170-210). Mean blood loss was 100 cc and no patient required transfusion. Mean hospital stay was four days., Conclusions: We believe this position is a good alternative for the management of the distal ureter during the laparoscopic approach. The technique is very similar to open surgery, which continues being the gold standard today.
- Published
- 2007
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34. [Laparoscopic nephron sparing surgery. Initial experience].
- Author
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Aguilera Bazán A, Alonso y Gregorio S, Pérez Utrilla M, Cansino Alcalde JR, Cisneros Ledo J, and De la Peña Barthel J
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Kidney Neoplasms surgery, Laparoscopy, Nephrectomy methods
- Abstract
We present our initial experience in laparoscopic nephron sparing surgery. It's a technically advanced procedure requiring considerable minimally invasive expertise. This technique is particularly attractive compared to an open conventional procedure with its larger incision and associated morbidity.
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- 2007
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35. [Open and laparoscopic adrenalectomy. 10 years review].
- Author
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Aguilera Bazán A, Pérez Utrilla M, Alonso y Gregorio S, Cansino Alcaide R, Cisneros Ledo J, and De la Peña Barthel J
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Time Factors, Adrenalectomy methods, Laparoscopy
- Abstract
We present a 10 years open adrenalectomy review in our Service and the beginning of laparoscopic adrenalectomy in the last year as a part of the retroperitoneal laparoscopic program at the Hospital Universitario La Paz . The first laparoscopic adrenalectomy was done after 21 retroperitoneal laparoscopic surgeries. Our initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
- Published
- 2006
- Full Text
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36. [Bladder neurofibroma: case report and bibliographic review].
- Author
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Cabrera Castillo PM, Alonso y Gregorio S, Cansino Alcaide JR, Aguilera Basan A, and De La Peña Barthel JJ
- Subjects
- Female, Humans, Middle Aged, Neurofibroma diagnosis, Urinary Bladder Neoplasms diagnosis
- Abstract
Objective: The prevalence of the disease is 1/3000 newborns; it is more frequent in men than in women with a 3:1 ratio in all races. Genitourinary tract neurofibromas usually arise from the pelvic and bladder nerves, and the prostatic plexus. Bladder is the most frequently affected organ of the urinary tract; bladder neurofibromatosis may present as a diffuse infiltrative process or an isolated neurofibroma. Bladder neurofibromas arise from nervous ganglia of the bladder wall and stain positive for protein S-100 and type IV collagen with immunohistochemical techniques., Methods: We performed a bibliographic review about urinary tract neurofibromas, and specifically of bladder neurofibroma. We report the case of a 45-year-old female consulting for voiding symptoms and recurrent urinary tract infections. Imaging tests showed a mass in the left lateral wall of the bladder and diffuse thickening of the bladder wall. The thickening of the bladder wall is the most characteristic finding in imaging tests, which may also be present in other diseases such as inflammatory pseudotumor and leiomyoma, so that final diagnosis should be achieved by pathologic study., Results: The case is relevant for the absence of previous diagnosis of neurofibromatosis, being bladder involvement its clinical debut. This is why it was difficult to suspect the final diagnosis: the absence of other characteristic clinical manifestations of the disease. Transurethral resection of the tumor was performed and pathologic and immunohistochemical studies offered the final diagnosis. The patient was followed in the urology clinic and also sent to the internal medicine department to rule out other organs involvement of the disease., Conclusions: Neurofibromatosis is a rare systemic disease, and urinary tract involvement is rarer. Bladder is the most frequently involved organ in the urinary tract, generally as a diffuse infiltration or more rarely a solitary tumor. The final diagnosis is pathological and immunohistochemical. Treatment is usually conservative. The patient should be worked up to rule out other manifestations of the disease, and followed to evaluate the development of new lesions.
- Published
- 2006
- Full Text
- View/download PDF
37. [Retroperitoneal laparoscopic surgery; initial experience in the Hospital La Paz].
- Author
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Aguilera Bazán A, Alonso y Gregorio S, Cansino Alcaide R, Hidalgo Togores L, Cisneros Ledo J, and de la Peña Barthel J
- Subjects
- Adult, Aged, Female, Humans, Laparoscopy adverse effects, Male, Middle Aged, Postoperative Complications, Spain, Treatment Outcome, Laparoscopy methods, Retroperitoneal Space surgery
- Abstract
We present the initial results of retroperitoneal laparoscopic surgery in the Hospital Universitario La Paz from July 2004 to December 2004. The program started after 2 years of pelvic laparoscopy surgery practice. The initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
- Published
- 2005
- Full Text
- View/download PDF
38. [Ureteroenteric strictures: endourological treatment].
- Author
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Cansino Alcaide JR, Pacios Cantero JC, Alonso y Gregorio S, Cáceres Jimenez F, Sánchez Rodriguez C, Aguilera Bazán A, Hidalgo Togores L, and De la Peña Barthel JJ
- Subjects
- Aged, Carcinoma complications, Catheterization, Female, Fluoroscopy, Follow-Up Studies, Humans, Intestinal Neoplasms complications, Male, Middle Aged, Patient Acceptance of Health Care, Postoperative Complications, Radiography, Interventional, Retrospective Studies, Stents, Treatment Outcome, Ureteroscopy methods, Urinary Bladder Neoplasms complications, Intestinal Obstruction surgery, Ureteral Obstruction surgery
- Abstract
Objectives: To review the outcomes of the ureteroenteric strictures treated by endourological techniques in our department, and to compare our long-term results with other reported series with similar follow-up and number of patients., Methods: We retrospectively reviewed 27 ureteroenteric strictures treated from March 1994 to June 2003, with a mean follow-up of 30.2 months (1 day-53 months). 13 cases underwent ballon dilation + permanent double J catheter (3 of them antegrade) 8 patients underwent endoscopical incision + double J catheter (5 of them with Acucise)., Results: 12/21 (57,14%) renal units improved and/or remained stable. We emphasize the absence of peroperative complications except 1 case that had a very poor oncological prognosis and died of septicemia 1 day after balloon dilation., Conclusions: Endourological treatment of ureteroenteric strictures has demonstrated to provide good fuctional results on the short and mid-term in patients that open surgery, although being the treatment of choice, would be too aggressive due to their disease, age, morbid conditions,....
- Published
- 2005
- Full Text
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39. [Use of intrarectal lidocaine gel in ultrasound-guided transrectal biopsies of the prostate].
- Author
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García Mediero JM, Martínez-Piñeiro Lorenzo L, Núñez Mora C, de Fata Chillón FR, Cruz Jimeno JL, Alonso y Gregorio S, and de la Peña Barthel JJ
- Subjects
- Adenocarcinoma diagnostic imaging, Administration, Rectal, Adult, Aged, Aged, 80 and over, Biopsy adverse effects, Biopsy methods, Gels, Humans, Male, Middle Aged, Prostatic Neoplasms diagnostic imaging, Ultrasonography, Adenocarcinoma pathology, Anesthetics, Local administration & dosage, Lidocaine administration & dosage, Pain, Postoperative prevention & control, Prostatic Neoplasms pathology
- Abstract
Objective: To know in a quantitative manner the degree of discomfort and pain of the biopsies of the prostate and to evaluate the effectiveness of the transrectal lidocaine., Material and Method: We performed 140 transrectal biopsies of the prostate, Patients were included on a random basis into two arms: one of them received intrarectal lidocaine, 20 mg (group 1, n = 71) and the other group received placebo (group 2, n = 28) both of them ten minutes prior the proceeding., Results: The global pain mean was 3.7 (0 no pain, 10 highest pain) and the global discomfort mean was 3.5. The group 1 patients showed a trend to feel less pain and discomfort although it did not reach the necessary statistic significance (p = 0.7 y p = 0.5 respectively)., Conclusions: We do not achieve the good results obtained by other groups in order to decrease the degree of pain and discomfort with the use of intrarectal lidocaine. We did not find relationship between the PSA level, previous biopsies, intrarectal lidocaina and degree of information received and the degree of pain and discomfort.
- Published
- 2003
- Full Text
- View/download PDF
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