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Objective In the following study, we observe the progress of various invasive calculi treatments that have taken place in our hospital in the last 15 years. Materials and methods We extracted data from our hospital database on patients who underwent extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery and open surgery. We analyzed how the incidence of these treatments has evolved over the last 15 years. We also studied the number of publications in PubMed that reference invasive calculi treatments. Results From January 1998 to December 2012, a total of 10,947 patients were treated instrumentally for lithiasis, 9695 of whom (90.4%) underwent ESWL and 1034 of whom underwent endoscopic or open surgery (9.6%). The incidence of lithotripsy treatments reached its maximum in 2006, with a progressive reduction thereafter. The incidence of endoscopic surgery increased progressively until 2009 and then leveled off. We can see how in recent years there has been a clear increase in the number of studies that have covered endoscopic surgery, with a decreasing number covering ESWL. Conclusions In our community, ESWL remains the most widely used invasive treatment for calculi. In recent years, there has been a reduction in the number of ESWL treatments and an increase in the number of endoscopic treatments, with open surgery showing a clearly decreasing trend.

Resumen Objetivo En el siguiente trabajo se revisa la evolucion de los diferentes tratamientos invasivos de la litiasis que se ha producido en nuestro hospital en los ultimos 15 anos. Material y metodo Se han extraido de la base de datos de nuestro hospital los pacientes intervenidos de litotricia extracorporea por ondas de choque (LEOC), de cirugia endoscopica y de cirugia abierta y se ha analizado como ha evolucionado la incidencia de estos tratamientos en los ultimos 15 anos. Asi mismo se ha estudiado el numero de publicaciones en PubMed que hacen referencia a los tratamientos invasivos de la litiasis. Resultados Desde enero de 1998 hasta diciembre de 2012 se han tratado instrumentalmente de litiasis un total de 10.947 pacientes, 9.695 pacientes (90,4%) de LEOC y 1.034 pacientes de cirugia (9,6%), endoscopica o abierta. La incidencia de tratamientos con litotricia ha tenido su maximo en 2006, presentando posteriormente una disminucion progresiva. La incidencia de la cirugia endoscopica ha aumentado progresivamente hasta 2009 para luego mantenerse. Vemos como en los ultimos anos existe un aumento claro de los articulos que tratan de cirugia endoscopica, disminuyendo los trabajos de LEOC. Conclusiones La LEOC sigue siendo en nuestro medio el tratamiento invasivo para la litiasis mas empleado. En los ultimos anos ha habido una disminucion de los tratamientos de LEOC y un aumento de los tratamientos endoscopicos, presentando la cirugia abierta una clara tendencia a la baja.

Resumen Introduccion El trasplante de pancreas supone, hoy dia, la unica alternativa terapeutica capaz de restablecer una absoluta normalidad en las cifras de glucemia en el paciente diabetico; ademas, va a frenar e incluso revertir las complicaciones derivadas de la diabetes. El objetivo de nuestro estudio es presentar la experiencia y los resultados de los 4 primeros anos del programa de trasplante pancreatico en nuestro centro. Material y metodo Desde febrero de 2000 hasta junio de 2004 se han realizado en el Hospital Regional Carlos Haya de Malaga 43 trasplantes de pancreas en 42 receptores. En todos los pacientes se ha utilizado la tecnica de drenaje enterico de la secrecion exocrine y la derivacion venosa sistemica (a cava inferior) para la endocrina. Resultados Treinta y siete (88,1%) casos fueron trasplantes simultaneos pancreas-rinon (SPR), 4 (9,5%) en pacientes con rinon previamente trasplantado (PDR) y en 1 (2,4%) caso se trato de un retrasplante. En todos los casos se consiguio la normalizacion de la hemoglobina glucosilada y del peptido C. La supervivencia del paciente y del injerto pancreatico han sido del 91 y del 84%, respectivamente, con una mediana de seguimiento de 19 meses. La tasa de reintervenciones ha sido del 31%, con un 16% del global de perdida del injerto. Conclusiones Nuestros resultados obtenidos son equiparables a lo publicado por las grandes series.

In the following study, we observe the progress of various invasive calculi treatments that have taken place in our hospital in the last 15 years.We extracted data from our hospital database on patients who underwent extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery and open surgery. We analyzed how the incidence of these treatments has evolved over the last 15 years. We also studied the number of publications in PubMed that reference invasive calculi treatments.From January 1998 to December 2012, a total of 10,947 patients were treated instrumentally for lithiasis, 9,695 of whom (90.4%) underwent ESWL and 1,034 of whom underwent endoscopic or open surgery (9.6%). The incidence of lithotripsy treatments reached its maximum in 2006, with a progressive reduction thereafter. The incidence of endoscopic surgery increased progressively until 2009 and then leveled off. We can see how in recent years there has been a clear increase in the number of studies that have covered endoscopic surgery, with a decreasing number covering ESWL.In our community, ESWL remains the most widely used invasive treatment for calculi. In recent years, there has been a reduction in the number of ESWL treatments and an increase in the number of endoscopic treatments, with open surgery showing a clearly decreasing trend.

Pancreatic transplantation is currently the only therapeutic alternative able to restore normal blood glucose levels in diabetic patients. Moreover, this procedure can halt or even reverse diabetes-related complications. The aim of this study was to present our experience and the results of the first 4 years of a pancreatic transplantation program in our center.From February 2000 to June 2004, 43 pancreatic transplantations were performed in 42 recipients in the Carlos Haya Regional Hospital in Malaga (Spain). In all patients, the technique of enteric drainage of exocrine pancreatic secretions and systemic venous shunting of endocrine secretions (to the inferior vena cava) was used.There were 37 (88.1%) simultaneous pancreas-kidney transplantations, 4 (9.5%) in patients with prior kidney transplantation and 1 retransplantation (2.4%). In all patients, glycosylated hemoglobin and C-peptide levels returned to normal. Patient and pancreatic graft survival were 91% and 84%, respectively, with a median follow-up of 19 months. The reintervation rate was 31%, with an overall rate of graft loss of 16%.The results obtained in our series are similar to those reported for large series.

The present study was performed in ten cases of hyperparathyroidism with a history of recurrent renal colic with or without passing calculi. Most of these patients had undergone stone surgery. Diagnosis was based on patient history, and metabolic and radiologic work up, and confirmed histologically following surgical exploration of the neck and removal of the pathologic parathyroid gland.