89 results on '"Cisneros Ledo J"'
Search Results
2. Laparoscopic adrenalectomy. Five-year experience
- Author
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Aguilera Bazán, A., Pérez Utrilla, M., Álvarez Escolá, C., Reinoso, J., Fernández Martínez, A., Cisneros Ledo, J., and de la Peña Barthel, J.
- Published
- 2010
- Full Text
- View/download PDF
3. [Neuroectodermic renal tumor. Case report and bibliographic review.]
- Author
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Orozco Fariñas R, Iglesias Prieto JI, Cisneros Ledo J, Massarrah Halabi J, Mancebo Gómez JM, and Perez-Castro Ellendt E
- Subjects
- Adolescent, Female, Humans, Nephrectomy, Prognosis, Sarcoma, Ewing, Kidney Neoplasms
- Abstract
We report the case of a 16 year old female who underwent left radical nephrectomy for a 13.2 cm neuroectodermic renal tumor and posterior chemo and radiotherapy in the Quiron Hospitals in Madrid and Complejo Hospitalario de Toledo, with a current survival of 14 months. Medical literature was reviewed for the historical, clinical, etiopathogenic, diagnostic, prognostic, therapeutic and survival features. We estimate the number of published cases to date. We also address the treatment performed and its results under a critical view.
- Published
- 2019
4. Derivaciones urinarias laparoscópicas
- Author
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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
5. Cirugía retroperitoneal laparoscópica: Experiencia del Hospital Universitario La Paz
- Author
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Aguilera Bazán, A., Pérez Utrilla, M., Martín, M., Pintado Otero, R., Cisneros Ledo, J., and Peña Barthel, J. de la
- Subjects
Laparoscopia ,Retroperitoneo ,Cirugía renal ,Donante vivo ,Living donor ,Suprarrenal ,Renal surgery ,Laparoscopy ,Retroperitoneal - Abstract
Objetivo: Con la popularización de la prostatectomía radical laparoscópica, dicha técnica vuelve a tomar un papel importante en el funcionamiento de los servicios de urología. Nuestra mayor experiencia en laparoscopia hace que cada vez realicemos más intervenciones mediante este abordaje. En este sentido, la cirugía retroperitoneal probablemente se beneficie más claramente que la prostática de la cirugía mínimamente invasiva. En este artículo describimos nuestra serie de casi 4 años. Métodos: El periodo analizado abarca desde Junio 2004 hasta Marzo 2008, durante el cual se han llevado a cabo 288 cirugías retroperitoneales (179 nefrectomías, 109 procedimientos varios). La vía de abordaje ha sido tranperitoneal en la gran mayoría de los casos. Resultados: La estancia hospitalaria media fue de 3,6 días para las nefrectomías y 3 días para los otros procedimientos. La tasa de transfusión de las nefrectomías es del 5% y un 2% de reconversión. En las cirugías variadas el porcentaje de transfusión fue del 6% y no existió ninguna reconversión. Conclusiones: La expansión de la laparoscopia en Urología debe venir acompañada de una buena selección de pacientes y una progresiva adquisición de experiencia por parte del cirujano. Determinadas intervenciones deberán ser abordadas únicamente en caso de gran experiencia. Objectives: With the popularisation of laparoscopic radical prostatectomy, the above technique has once again taken on an important role in the work of urology departments. Our extensive experience in laparoscopy means that we are performing increasingly more interventions using this approach. In the context of minimally invasive surgical procedures, this is probably bringing clearer benefits to retroperitoneal surgery than to prostatic surgery. In this article, we describe our series over nearly 4 years. Methods: The period analysed covers June 2004 to March 2008, during which time 288 retroperitoneal operations were performed (184 nephrectomies, 113 other procedures). In the majority of cases, the route of approach was transperitoneal. Results: The mean hospital stay was 3.6 days for the nephrectomies and 3 days for the other procedures. The transfusion rate for the nephrectomies was 5% and there was a conversion rate of in 2%. In the other types of surgery, the transfusion rate was 6% and there were no conversions. Conclusions: The expansion of laparoscopy in Urology has to be accompanied good patient selection and the progressive acquiring of experience on the part of the surgeon. Certain interventions should only be tackled in cases where there is extensive experience.
- Published
- 2008
6. Autotrasplante renal laparoscópico experimental como modelo de aprendizaje de técnica laparoscópica
- Author
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Aguilera Bazán, A., Betancourt, F., Murillo, S., Benito de la Víbora, J., Cisneros Ledo, J., and de la Peña Barthel, J.
- Subjects
Entrenamiento laparoscópico ,Renal autograft ,Irrigación ,Training laparoscopy ,Vascular laparoscopy ,Autotrasplante renal ,Irrigation ,Laparoscopia vascular - Abstract
Introducción: La cirugía laparoscópica requiere un largo proceso de aprendizaje en el que se va aumentando progresivamente el grado de complejidad. Objetivo: La técnica aquí presentada se ha realizado buscando un modelo experimental que nos permita realizar sutura vascular laparoscópica, de manera que el objetivo inmediato no es conseguir un autotrasplante funcionante, sino realizar con éxito anastomosis vasculares. Presentamos nuestra experiencia en los dos primeros casos realizados. Material y método: Se realizó el autotrasplante renal laparoscópico en hembras de cerdo de entre 15 y 20 kg. El Servicio de Cirugía Experimental del Hospital Universitario La Paz revisó y aprobó los protocolos del experimento, tal como exigen los Dictámenes Europeos para la protección de los animales utilizados con fines científicos y experimentales (86/609/EEC). Resultados: Al sacrificar a los animales, sólo observamos un caso con trombosis vascular arterial. El resto de animales presentaban buen flujo arterial y venoso. Conclusiones: El autotrasplante renal laparoscópico experimental proporciona un buen modelo para aprendizaje de cirugía laparoscópica. Creemos que aporta recursos laparoscópicos adecuados para cirugía retroperitoneal y pélvica. No proponemos, en el momento actual, su aplicación a la cirugía laparoscópica en humanos. Introduction: Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. Goals: The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vacular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed. Material and methods: Laparoscopic renal autotransplant was perfomed in female lab pigs weighing 15-20 kg. International Experimental Animal Care rules were accomplished. Results: After sacrifizing the animals, only one case of vascular thrombosis was observed. The other cases showed normal arterial and venous flow. Conclusions: Experimental Renal Laparoscopic autotransplant constitutes a good surgical model. We are trying to implement the technique in the clinics in the next future.
- Published
- 2008
7. 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.
- Subjects
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
8. Suprarrenalectomía abierta y laparoscópica: Revisión de 10 años
- Author
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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
- Subjects
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
9. Implantación de un programa de prostatectomía radical laparoscópica
- Author
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Cansino Alcaide, J.R., Cabrera Castillo, P.M., Álvarez Maestro, M., Martínez-Piñeiro Lorenzo, L., Cisneros Ledo, J., and De la Peña Barthel, J.
- Subjects
Laparoscopia ,Cáncer de próstata ,Prostate cancer ,Prostatectomía radical ,Laparoscopy ,Radical prostatectomy - Abstract
En el deseo de éste artículo, está expresar nuestra experiencia a la hora de poner en práctica un programa de prostatectomía radical laparoscópica. Pensamos que puede ser interesante, de cara a implantar un programa de éste tipo, conocer cuáles fueron nuestras dificultades al inicio. Esperamos que en la medida de lo posible, podamos facilitar ésta difícil tarea, explicando qué pasos hemos seguido y cuáles son nuestras conclusiones y recomendaciones The aim of this article is to report our experience in setting up a laparoscopic radical prostatectomy programme. We believe that knowledge of the difficulties we faced at the start will be useful for those who wish to implement a programme like ours. We hope that by explaining the steps we took as well as our conclusions and recommendations this difficult task can be made easier.
- Published
- 2006
10. Cirugía retroperitoneal laparoscópica: experiencia de los 6 primeros meses del 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 Peña Barthel, J. de la
- Subjects
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
11. Autotransplante renal laparoscópico experimental
- Author
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Aguilera Bazán, A., Murillo, S., Benito de la Víbora, J., Cisneros Ledo, J., and Peña Barthel, J. de la
- Subjects
Entrenamiento laparoscópico ,Renal autograft ,Irrigación ,Training laparoscopy ,Vascular laparoscopy ,Irrigation ,Autotransplante renal ,Laparoscopia vascular - Abstract
La cirugía laparoscópica requiere un largo proceso de aprendizaje en el que se va aumentando progresivamente el grado de complejidad. La técnica aquí presentada se ha realizado buscando un modelo experimental que nos permita realizar sutura vascular laparoscópica, de manera que el objetivo inmediato no es conseguir un autotransplante funcionante, sino realizar con éxito anastomosis vasculares. Presentamos nuestra experiencia en los dos primeros casos realizados. Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vascular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed.
- Published
- 2004
12. Extramedullary plasmacytoma of the testicle.
- Author
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Carrion DM, Álvarez-Maestro M, Gómez Rivas J, González-Peramato P, and Cisneros Ledo J
- Subjects
- Humans, Male, Middle Aged, Multiple Myeloma pathology, Testicular Neoplasms pathology
- Abstract
Objective: We present the case of a patient diagnosed with a testicular extramedullary plasmacytoma (EMP), and perform a brief review of the literature of this pathology., Methods: A 64 year-old male patient, with history of multiple myeloma successfully treated three years before, presented with left testicular swelling. Initial work-up was compatible with a testicular tumor and radical inguinal orchiectomy was performed., Results: Histologic examination of the testis revealed extensive intertubular infiltration by CD138 and CD56 atypical plasma cells, with diffuse staining for IgA, compatible with EMP., Conclusions: Invasion of the testis in multiple myeloma patients as a recurrence of the disease is an extremely rare condition, as EMPs are more common in other organ systems. Initial treatment should be the same as a primary testicular tumor with radical inguinal orchiectomy, and definitive diagnosis is established in histologic analysis.
- Published
- 2017
13. 556 Iatrogenic ureteral stricture: Laparoscopic ureteral reimplantation
- Author
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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
14. 1036 Laparoscopic radical cystectomy with prostate capsule sparing. Oncologic and functional results: Our experience
- Author
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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
15. Cirugía conservadora de parénquima renal laparoscópica: Cinco años de experiencia
- Author
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Aguilera Bazán, A., primary, Pérez Utrilla, M., additional, Girón de Francisco, M., additional, Reinoso Elbers, J., additional, Cisneros Ledo, J., additional, and Peña Barthel, J. De la, additional
- Published
- 2010
- Full Text
- View/download PDF
16. Suprarrenalectomía laparoscópica: Experiencia de 5 años
- Author
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Aguilera Bazán, A., primary, Pérez Utrilla, M., additional, Álvarez Escolá, C., additional, Reinoso, J., additional, Fernández Martínez, A., additional, Cisneros Ledo, J., additional, and Peña Barthel, J. de la, additional
- Published
- 2010
- Full Text
- View/download PDF
17. A Review of Penile Cancer
- Author
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Rando Sous, A., primary, Pérez-Utrilla Pérez, M., additional, Aguilera Bazán, A., additional, Tabernero Gomez, A., additional, Cisneros Ledo, J., additional, and De la Peña Barthel, J., additional
- Published
- 2009
- Full Text
- View/download PDF
18. 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
19. Cirugía retroperitoneal laparoscópica: Experiencia del Hospital Universitario La Paz
- Author
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Aguilera Bazán, A., primary, Pérez Utrilla, M., additional, Martín, M., additional, Pintado Otero, R., additional, Cisneros Ledo, J., additional, and Peña Barthel, J. de la, additional
- Published
- 2008
- Full Text
- View/download PDF
20. Autotrasplante renal laparoscópico experimental como modelo de aprendizaje de técnica laparoscópica
- Author
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Aguilera Bazán, A., primary, Betancourt, F., additional, Murillo, S., additional, Benito de la Víbora, J., additional, Cisneros Ledo, J., additional, and de la Peña Barthel, J., additional
- Published
- 2008
- Full Text
- View/download PDF
21. Cirugía renal laparoscópica conservadora de parénquima: Experiencia inicial
- Author
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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
22. 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
23. Implantación de un programa de prostatectomía radical laparoscópica
- Author
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Cansino Alcaide, J.R., primary, Cabrera Castillo, P.M., additional, Álvarez Maestro, M., additional, Martínez-Piñeiro Lorenzo, L., additional, Cisneros Ledo, J., additional, and De la Peña Barthel, J., additional
- Published
- 2006
- Full Text
- View/download PDF
24. Cirugía retroperitoneal laparoscópica: experiencia de los 6 primeros meses del Hospital La Paz
- Author
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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
25. A novel heterozygous mutation in the Birt-Hogg-Dubé Syndrome.
- Author
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Gómez Rivas J, Carrión DM, Alonso Y Gregorio S, Álvarez-Maestro M, Tabernero Gómez Á, and Cisneros Ledo J
- Subjects
- 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
26. [Principles of urinary tract reconstructive surgery.]
- Author
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Gomez Rivas J and Cisneros Ledo J
- Subjects
- Humans, Laparoscopy, Urinary Tract surgery, Urologic Surgical Procedures methods
- Abstract
Introduction: In the last 15 years, the role of laparoscopic surgery has progressively increased to include reconstructive procedures such as pyeloplasty and management of ureteral stricture, in addition to being a field in continuous development, this refers to the improvement of ergonomics, new instruments and new techniques. We present a review on basic features of laparoscopic reconstructive surgery in urology., Acquisition of Evidence: For this review, an exhaustive literature search was performed in PUBMED, MEDILNE, BioMed central and others, with the keywords: reconstructive surgery, urology, laparoscopy. Only articles including urologic procedures in the adult and published in the last 6 years, were selected for this review., Synthesis of Evidence: One of the objectives of any urological reconstructive procedure is to treat any segment of the genitourinary tract that is obstructed due to scar tissue following trauma or iatrogenic causes. After the excision of such segment or scar, a mobilization of the 2 healthy extremities of the urinary tract must be performed in order to proceed with a tension-free anastomosis. Occasionally, if there is tension, a mobilization of the organs at each side of the lesion should be performed to reduce the tension of the anastomosis; also, it should be a water-tight anastomosis to ensure good functional results. Another type of procedure is to perform laparoscopic repair surgery of pelvic organ prolapse in which the vaginal anatomy should be adequately restored, with good function maintained (sexual, urinary, intestinal) and durability., Conclusions: With the worldwide expansion of minimally invasive surgery in the area of laparoscopy and robotics, it has been possible to reproduce many of the reconstructive techniques that have followed the evolutionary course of surgery from the open to the robot assisted technique, which has made clear that such therapeutic options exist and are reproducible with good results.
- Published
- 2017
27. Autotransplante renal laparoscópico experimental
- Author
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Aguilera bazán, A., primary, Cisneros ledo, J., additional, De la peña barthel, J., additional, Murillo, S., additional, and Benito de la víbora, J., additional
- Published
- 2004
- Full Text
- View/download PDF
28. Simultaneous Cystectomy and Nephroureterectomy due to Synchronous Upper Urinary Tract Tumors and Invasive Bladder Cancer: Open and Laparoscopic Approaches.
- Author
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Pérez-Utrilla Pérez M, Aguilera Bazán A, Alonso Dorrego JM, Vitón Herrero R, Cisneros Ledo J, and de la Peña Barthel J
- Abstract
Introduction: It is not unusual for bladder tumors to appear following transitional cell carcinoma of the upper urinary tract (UUT), with involvement of the UUT, following invasive bladder cancer, being less common. The synchronous presence of transitional cell carcinoma of the bladder and of the UTT is exceptional., Methods: Fifteen simultaneous cystectomies with nephroureterectomies were performed due to synchronous UUT and invasive bladder cancers (1997-2009). Surgery was performed using an open approach in 10 patients, while the last 5 procedures were performed laparoscopically., Results: The mean age was 68.7 years. Mean surgery time was 348.6 minutes. Mean blood loss was 816 ml. Acute renal failure was the most frequent postoperative complication being present in 5 patients (33%). There was 1 case of a leak in the ureter-intestinal anastomosis (open approach), which required placement of a left-sided percutaneous nephrostomy. There were 2 cases of postoperative mortality, both in the open approach series and with intestinal neobladder. Mean follow-up time for the whole series was 21.25 months. Eight cases experienced metastatic progression of the disease (mean follow-up 17 months)., Conclusion: Though multi-site studies with longer follow-up and a greater numbers of patients are needed, the moment at which urothelial tumors appear seems to influence their prognosis, with lower survival rates for tumors that synchronically appear.
- Published
- 2012
- Full Text
- View/download PDF
29. A review of penile cancer.
- Author
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Sous, A. Rando, Pérez, M. Pérez-Utrilla, Bázan, A. Aguilera, Gomez, A. Tabernero, Ledo, J. Cisneros, Barthel, J. De la Peña, Rando Sous, A, Pérez-Utrilla Pérez, M, Aguilera Bazán, A, Tabernero Gomez, A, Cisneros Ledo, J, and De la Peña Barthel, J
- Subjects
PENILE cancer ,OLDER patients ,CANCER in men ,ADJUVANT treatment of cancer ,MEDICAL records ,TOMOGRAPHY ,BLEOMYCIN ,METHOTREXATE ,MEN ,SURGERY - Abstract
Unlabelled: Cancer of the penis is a rare tumour in Europe and mainly affects the elderly patient population. The aim of this paper was to analyse and study the characteristics of this tumour, in our patient population.Materials and Methods: A retrospective study was conducted on penile tumours diagnosed and treated in the Urology Department of the Hospital Universitario La Paz, Madrid, in the last ten years.Results: A total of 34 patients were diagnosed and treated. The mean age at presentation was 71.27 years. The mean time between symptoms and the first consultation was 12.54 months with a median of 6 months. The most common form of presentation was balanoposthitis (32%) and the most common site in our series was the glans. Partial penectomy was performed in 22 cases, total amputation in 8, and local excision in 3.Discussion: Carcinoma of the penis is a pathology which mostly affects elderly patients; in our series, the highest incidence was observed in patients in the group aged 75-84 years. The most common histological type was epidermoid carcinoma in its various forms of presentation. We recorded a mortality of 23%.Conclusion: Penile carcinoma is a rare pathology which affects elderly persons and is diagnosed late. [ABSTRACT FROM AUTHOR]- Published
- 2009
- Full Text
- View/download PDF
30. [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
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- View/download PDF
31. [Laparoscopic radical nephrectomy. Procedure, results, and complications].
- Author
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Aguilera Bazán A, Pérez Utrilla M, Girón M, Cisneros Ledo J, and de la Peña Barthel J
- Subjects
- Humans, Treatment Outcome, Kidney Neoplasms surgery, Laparoscopy, Nephrectomy adverse effects, Nephrectomy methods
- Abstract
Surgery is the treatment of choice for clear cell renal carcinoma not responding to chemotherapy, radiotherapy, or immunotherapy. The surgical procedure used has evolved over time in the past 40 years, mainly because of the development and widespread use of diagnostic procedures such as ultrasonography and CT. As a direct consequence, parenchymal-sparing surgery was no longer only used for patients with solitary kidneys and its indication started to be extended to patients with tumors up to 4 cm in diameter, in whom it has been shown to be a safe and effective alternative to radical nephrectomy. The other important milestone in development of renal cancer surgery undoubtedly was the revolution started in the 90s with advent of laparoscopic renal surgery, which has become established over the past 20 years approximately. Laparoscopic surgery initially raised concern about oncological safety, but clinical series with sufficiently long follow-up times and large sample sizes are now available to consider the laparoscopic approach as a reliable procedure. Technological development has caused the laparoscopic technique to be no longer seen as a procedure for the future, but rather as an absolutely current technique which should be implemented in most urology departments. Implementation of any new procedure usually involves a number of complications which we should be prepared to assume, while making every effort to try and prevent them. It is therefore essential to develop, and to implement using common sense, a training program on the procedure. Selection of patients and conditions to be treated is a crucial part of such a program.
- Published
- 2009
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- View/download PDF
32. [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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- View/download PDF
33. [Experimental laparoscopic renal autograft as learning laparoscopic model].
- Author
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Aguilera Bazán A, Betancourt F, Murillo S, Benito de la Víbora J, Cisneros Ledo J, and de la Peña Barthel J
- Subjects
- Animals, Female, Models, Animal, Swine, Kidney Transplantation education, Kidney Transplantation methods, Laparoscopy
- Abstract
Introduction: Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased., Goals: The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vacular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed., Material and Methods: Laparoscopic renal autotransplant was perfomed in female lab pigs weighing 15-20 kg. International Experimental Animal Care rules were accomplished., Results: After sacrifizing the animals, only one case of vascular thrombosis was observed. The other cases showed normal arterial and venous flow., Conclusions: Experimental Renal Laparoscopic autotransplant constitutes a good surgical model. We are trying to implement the technique in the clinics in the next future.
- Published
- 2008
- Full Text
- View/download PDF
34. [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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- View/download PDF
35. [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.
- Published
- 2007
- Full Text
- View/download PDF
36. A novel study, textbook outcome in adrenalectomy: retrospective observational study in an endocrine surgical unit.
- Author
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Rubio-García, J. J., Gil Navarro, R., Franco Campello, M., Costa Navarro, R., Gomis Martín, A., Villodre Tudela, C., Zaragoza Zaragoza, C., Carrión Tomás, A., and Ramia-Ángel, J. M.
- Abstract
Textbook outcome is a multidimensional quality management tool that uses a set of traditional surgical measures to reflect an "ideal" surgical result for a particular pathology. Retrospective study of all patients undergoing scheduled for adrenal tumors surgery at an endocrine surgery unit from January 2010-December 2022. The definition of Textbook Outcome were: R0 resection, no Clavien–Dindo ≥ IIIa complications, no prolonged stay (< P75), no readmissions, and no mortality in the first 30 days. The main objective was to analyze the rate of Textbook Outcome obtained. One hundred and five patients were included in the study. Textbook Outcome was achieved in 71.4%. Surgical approach (p < 0.001), Charlson scale (p = 0.031), American Society of Anesthesiologists Classification (p = 0.047) and surgical time (p < 0.001) were all significantly associated with the achievement of Textbook Outcome. The laparoscopic approach was associated as an independent factor with obtaining Textbook Outcome (OR:5.394; p = 0.016), as was surgical time (OR:0.986; p = 0.004). Textbook Outcome is a novel, useful, easy-to-interpret tool for measuring results in adrenal surgery. The laparoscopic approach is associated with a higher rate of "ideal" surgical results. The study was registered in the public accessible database clinicaltrials.gov with the ClinicalTrials.gov ID: NCT05888753. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
37. [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
- View/download PDF
38. [Development of a laparoscopic radical prostatectomy program in an university center].
- Author
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Cansino Alcaide JR, Cabrera Castillo PM, Alvarez Maestro M, Martínez-Piñeiro Lorenzo L, Cisneros Ledo J, and De la Peña Barthel J
- Subjects
- Animals, Computer-Assisted Instruction instrumentation, Equipment Design, Hospitals, University, Humans, Laparoscopy, Prostatectomy education, Prostatectomy methods
- Abstract
The aim of this article is to report our experience in setting up a laparoscopic radical prostatectomy programme. We believe that knowledge of the difficulties we faced at the start will be useful for those who wish to implement a programme like ours. We hope that by explaining the steps we took as well as our conclusions and recommendations this difficult task can be made easier.
- Published
- 2006
- Full Text
- View/download PDF
39. [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
40. [Experimental laparoscopic renal autograft].
- Author
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Aguilera Bazán A, Murillo S, Benito de la Víbora J, Cisneros Ledo J, and de la Peña Barthel J
- Subjects
- Animals, Female, Swine, Kidney Transplantation methods, Laparoscopy
- Abstract
Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vascular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed.
- Published
- 2004
- Full Text
- View/download PDF
41. [Early-onset sarcomatoid renal carcinoma. Report of a new case and comparison of the same case with another appearing at a mature age].
- Author
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García Mediero JM, Alonso Dorrego JM, Nuñez Mora C, Pastor Arquero T, De Fata FR, Cisneros Ledo J, Perez Mies B, Picazo García ML, and de la Peña Barthel YJ
- Subjects
- Adult, Age of Onset, Aged, Antineoplastic Agents, Phytogenic therapeutic use, Carcinosarcoma diagnosis, Carcinosarcoma epidemiology, Carcinosarcoma secondary, Carcinosarcoma surgery, Chemotherapy, Adjuvant, Disease Progression, Fatal Outcome, Female, Hepatectomy methods, Humans, Kidney Neoplasms diagnosis, Kidney Neoplasms epidemiology, Kidney Neoplasms surgery, Liver Neoplasms secondary, Lung Neoplasms secondary, Lymph Node Excision, Nephrectomy, Vincristine therapeutic use, Carcinosarcoma pathology, Kidney Neoplasms pathology
- Abstract
Objective and Methods: We report two new cases of this rare and aggressive tumour; one case appeared in the earliest age reported in the literature (case #2). We also review etiological, diagnostic and therapeutic features., Results: Despite aggressive surgery and adjuvant chemotherapy it has a very poor prognosis, with disease progression within 6 months in both cases., Conclusions: Sarcomatoid renal cell carcinoma is an infrequent entity, extremely aggressive and requires radical surgery at the time of diagnosis due to its advanced stage, although results are poor. It can also appear in young people with the same aggressiveness than in adult age.
- Published
- 2002
42. [Clinical pathway for TUR of bladder neoplasms. Analysis of the first 2 years of its implementation].
- Author
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Núñez Mora C, Chamorro Ramos L, Rendón Sánchez D, Ríos González E, Pastor Arquero T, Aguilera Bazán A, Tabernero Gómez A, Cisneros Ledo J, García Caballero J, and de la Peña Barthel JJ
- Subjects
- Follow-Up Studies, Humans, Time Factors, Urethra, Urologic Surgical Procedures methods, Critical Pathways, Urinary Bladder Neoplasms surgery
- Abstract
Objective: To analyze the results of the first two years of application of the clinical pathway for transurethral resection (TUR) of bladder tumors at La Paz University Hospital., Methods: We developed a clinical pathway of 4 hospital stays (5 days) for TUR of the bladder that included the following: matrix-verification, treatments prescribed, verification of changes, patient information sheet and patient satisfaction questionnaire. The information for the evaluation of the results were obtained from the pathway records and data on the activities of the Urology services. To assess the results for efficiency in the use of resources, the mean duration of hospital stay of patients in the pathway were compared with that of a control group comprised of 50 randomly selected patients submitted to TUR of the bladder in 1997., Results: From June 1998 to May 2000, 481 of the 494 (97.4%) treated patients entered the clinical pathway., Conclusions: In our experience, the clinical pathway for the urinary bladder is a useful instrument for developing the clinical management of this condition. It reduces the unwanted changes in patient care and hospital stay, carries a low incidence of complications and readmissions, and achieves a high degree of patient satisfaction.
- Published
- 2001
43. [Triple ureter with inverted ureteral branch in "y" with ectopic ending and calculi inside].
- Author
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Iglesias Prieto J, Cisneros Ledo J, Serrano JM, Rodríguez Ledesma JM, Massarra Halabi J, Pérez-Castro E, and Mancebo Gómez J
- Subjects
- Adult, Humans, Male, Ureter abnormalities, Ureteral Calculi complications
- Abstract
Objective: To report an uncommon case of ureteral duplication with a single intramural trajectory and a third ureter arising from the medial ureter, corresponding to the inferior pyelon, opening at the level of the bladder neck and containing a calculus measuring 10 mm along its longest axis, lodged in a saccular dilatation. The etiopathogenesis of this rare anomaly is briefly reviewed and discussed., Methods/results: Diagnosis was established endoscopically and pyelographically. Endoscopic resolution was not possible, but stone removal was successfully achieved by conventional surgery using the least invasive approach possible. The patient is asymptomatic 24 months postoperatively., Conclusion: Although infrequent, this condition should be suspected in those "unclear' cases seen in day-to-day urological practice. Symptoms of the associated pathology are more common than those arising from the anomaly. Treatment should be specific to each case, as least invasive as possible and should aim at symptomatic resolution.
- Published
- 1997
44. Extramedullary plasmacytoma of the testicle
- Author
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Dm, Carrion, Mario Álvarez-Maestro, Gómez Rivas J, González-Peramato P, and Cisneros Ledo J
45. [Extracorporeal shock wave lithotripsy (ESWL) in children: our experience in 1995].
- Author
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Butori G, Iglesias Prieto JI, Mancebo Gómez JM, Massarra Halabi J, Cisneros Ledo J, and Pérez-Castro Ellendt E
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Lithotripsy, Urinary Calculi therapy
- Abstract
Objectives: The present study reviews our experience and analyzes the results achieved with extracorporeal shock wave lithotripsy in the treatment of urinary calculi in children., Methods: From 1985 to 1995, 36 children, with ages ranging from 5 months to 14 years, were treated by ESWL, and in some cases by combination therapy (percutaneous nepholithectomy and/or ureteroscopy)., Results: Excellent results were achieved in 74.9% of the patients; of these, 52.7% were stone-free 2 to 90 days after treatment., Conclusions: Extracorporeal shock wave lithotripsy is the treatment of choice in children with urinary lithiasis, although there are some exceptions. The method of evaluation and treatment in children are the same as in the adult patients.
- Published
- 1996
46. Pyeloureteral Anastomosis as a Reconstructive Technique for Post-Renal Transplant Ureteral Stenosis.
- Author
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de la Parra, Irene, Rivas, Juan Gómez, Gutíerrez, Beatriz, Infante, Sarelis, Galindo, Isabel, Ciappara, Marco, Blázquez, Jesús, Gómez, Ángel, and Moreno-SIerra, Jesús
- Subjects
URETERIC obstruction ,MINIMALLY invasive procedures ,KIDNEY transplantation ,PLASTIC surgery ,RETROSPECTIVE studies ,QUANTITATIVE research ,QUALITATIVE research ,DESCRIPTIVE statistics ,DATA analysis software ,FRIEDMAN test (Statistics) ,URETER diseases - Abstract
Objective: Ureteral stenosis in renal transplant patients is a frequent urological complication that involves significant morbidity and may compromise graft function. Despite the common use of minimally invasive techniques, surgery continues to be the definitive treatment for ureteral stenosis, and pyeloureteral anastomosis is an infrequent but effective technique in the management of this pathology and has been described as a safe treatment with a low percentage of complications. Methods: This is a retrospective study of patients in whom surgical intervention via pyeloureteral anastomosis was carried out in our center in the last 12 years. A descriptive analysis of perioperative management, complications, and functional results is provided. A comparison of renal function at diagnosis and after surgery was made to evaluate the effectiveness of the procedure. Results: Thirteen patients underwent surgery within the described time frame. Time to diagnosis of stenosis was 60 days [interquartile range (IQR) 31-368]. Creatinine at diagnosis was 2.2 mg/dL [IQR 1.9-3] with a glomerular filtration rate, estimated by the modification of diet in renal disease equation, of 29 mL/min/1.73 m2 [IQR 22.6-34.5]. Of these patients, 92.3% underwent percutaneous nephrostomy, and 38.5% also had a ureteral catheter. The mean duration of surgery was 265 minutes [IQR 240-300], and hospital stay was 9 days [IQR 7.5-16]. A double J was placed in all cases, which was maintained for 36 days [IQR 30-49]. Postoperative complications occurred in 15.4% of patients. Serum creatinine 1 year after surgery was 1.6 ± 0.4 mg/dL. Among the patients, 76.9% had no new pyelocalyceal dilatation on follow-up Doppler ultrasound scans at a mean follow-up time of 12 months. The restenosis rate was 23.1%, and all were successfully treated by endoscopic approach. There was an improvement in renal function figures at 1, 3, 6, and 12 months compared to renal function at diagnosis, both in terms of serum creatinine and glomerular filtration rate, with statistically significant results. Conclusion: Pyeloureteral anastomosis as a reconstructive technique of the urinary tract in renal transplant patients is an effective and reproducible technique with good long-term results. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
47. [Treatment of idiopathic hydrocele by intravaginal injection of tetracycline].
- Author
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Mancebo Gómez JM, Massarra J, Cisneros Ledo J, Beneitez Alvarez M, Iglesias JI, and Pérez Castro Ellendt E
- Subjects
- Adolescent, Adult, Humans, Injections, Male, Middle Aged, Pain chemically induced, Recurrence, Tetracycline adverse effects, Testicular Hydrocele drug therapy, Tetracycline administration & dosage
- Published
- 1987
48. [Primary retroperitoneal tumors. Apropos of 11 cases].
- Author
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Martínez-Piñeiro JA, Pérez-Castro Ellendt E, Hernández Armero A, Cisneros Ledo J, and Avellana Fontanella JA
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Retroperitoneal Neoplasms diagnosis, Retroperitoneal Neoplasms surgery, Retroperitoneal Neoplasms pathology
- Published
- 1983
49. [Germinal tumor of the testicle, renal adenocarcinoma and tumor of the contralateral superior urothelium in the same patient: infrequent association of tumoral pathology].
- Author
-
Pérez-Castro Ellendt E, de la Peña Barthel J, Cisneros Ledo J, Machuca J, Hidalgo Togores L, Jiménez León J, and Martínez-Piñeiro JA
- Subjects
- Aged, Humans, Kidney Pelvis, Lymphatic Metastasis, Male, Neoplasms, Multiple Primary diagnostic imaging, Radiography, Adenocarcinoma pathology, Carcinoma, Papillary pathology, Dysgerminoma pathology, Kidney Neoplasms pathology, Neoplasms, Multiple Primary pathology, Testicular Neoplasms pathology
- Published
- 1984
50. Surgical benchmarks, mid-term oncological outcomes, and impact of surgical team composition on simultaneous enbloc robot-assisted radical cystectomy and nephroureterectomy.
- Author
-
Buse, Stephan, Alexandrov, Assen, Mazzone, Elio, Mottrie, Alexandre, and Haferkamp, Axel
- Subjects
CYSTECTOMY ,SURGICAL robots ,ILEAL conduit surgery ,TRANSITIONAL cell carcinoma ,MINIMALLY invasive procedures ,URINARY organs ,URINARY diversion - Abstract
Background: Simultaneous urothelial cancer manifestation in the lower and upper urinary tract affects approximately 2% of patients. Data on the surgical benchmarks and mid-term oncological outcomes of enbloc robot-assisted radical cystectomy and nephro-ureterectomy are scarce.Methods: After written informed consent was obtained, we prospectively enrolled consecutive patients undergoing enbloc radical cystectomy and nephro-ureterectomy with robotic assistance from the DaVinci Si-HD® system in a prospective institutional database and collected surgical benchmarks and oncological outcomes. Furthermore, as one console surgeon conducted all the procedures, whereas the team providing bedside assistance was composed ad hoc, we assessed the impact of this approach on the operative duration.Results: Nineteen patients (9 women), with a mean age of 73 (SD: 7.5) years, underwent simultaneous enbloc robot-assisted radical cystectomy and nephro-ureterectomy. There were no cases of conversion to open surgery. In the postoperative period, we registered 2 Clavien-Dindo class 2 complications (transfusions) and 1 Clavien-Dindo class 3b complication (port hernia). After a median follow-up of 23 months, there were 3 cases of mortality and 1 case of metachronous urothelial cancer (contralateral kidney).The total operative duration did not decrease with increasing experience (r = 0.174, p = 0.534). In contrast, there was a significant, inverse, strong correlation between the console time relative to the total operative duration and the number of conducted procedures after adjusting for the degree of adhesions and the type of urinary diversion(r = -0.593, p = 0.02).Conclusions: These data suggest that en bloc simultaneous robot-assisted radical cystectomy and nephro-ureterectomy can be safely conducted with satisfactory mid-term oncological outcomes. With increasing experience, improved performance was detectable for the console surgeon but not in terms of the total operative duration. Simulation training of all team members for highly complex procedures might be a suitable approach for improving team performance.Trial Registration: Not applicable. Video Abstract. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
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