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A Blanco Díez

Publications and source records attributed to A Blanco Díez.

14 recordsLinked to original sources
PubMed2005

[Role of nephrectomy in metastatic renal cell carcinoma. Experience of the Department of Urology Juan Canalejo Hospital].

OBJECTIVES: We expose our experience in nephrectomy in metastatic renal cell carcinoma, and also show complications, evolution and survival of these patients. MATERIAL AND METHODS: We performe a retrospective review of renal cell carcinoma treated at our service in the period between January 1st 1991 and December 31st 2002. We only studied those which presented in a metastatic pattern (31), and divide these in two groups: the ones which were nephrectomized and those which were not. We try to showw the differences between the two groups in order of status performance (E.C.O.G.), associated morbidity and median survival. In the first group we also study complications of surgery and treatment that patients underwent. RESULTS: we performed nephrectomy in 19 cases, all of them E.C.O.G. 0-1. Median postoperative stay was 12 days, and complication rate was 11.5%. Of these patients, 45% underwent some type of systemic treatment, and median survival was 31 months. We didn't performed nephrectomy in 12 patients, of which 9 were E.C.O.G. 2-3. Associated co-morbidity was higher in this group. Only in three patients any treatment was offered always with palliative reason. Median survival was 3.8 months. CONCLUSIONS: In those patients with good performance status this approach does not represent more morbility nor mortality than in non-metastatic patients, and that is a cornerstone in their management. We also make a literature review in which we see the last pathways in the management of these patients, and that show the needing for a combined approach both quirurgical and inmunotherapical. We have review with special interest the studie's conclusions of SWOG and EORTC groups.

Adult↗
PubMed2004

[Traumatic urethral disruption in women. A rare entity. Report of two cases].

We present two cases of urethral disruption in women, a very uncommon situation because of the anatomical features. Yet it must be always suspected in all women under a pelvic politraumatism, for eviting important problems. Both cases are traffic politraumatized young girls presenting with pelvic fracture, among others. The surgery performed was combined suprapubic-transvaginal approach, even in one a previous endoscopic realinement was done, who also needed endoscopic complementary treatment: electrofulguration of a fistulous bridge. Outcome of both is fine, achieving good continence. We also make a literature review.

Adolescent↗
PubMed2004

[Iatrogenic prostatorectal fistula. Use of gracilis muscle pedicled flap for its reparation. Presentation of two cases].

We present two cases in which during retropubic prostatectomy for benign prostatic disease a prostatorectal fistula ocurred. We describe its reparation using a pedicled flap of gracilis muscle. We also present cystographic and opaque enema images which shows the before and after of this surgery. Patients had good outcome without incontinence nor problems related to muscle desinsertion surgery.

Aged↗
PubMed2003

[Double-barreled wet colostomy: analysis of a urinary diversion].

We analyse our experience in performing the wet colostomy, also called urocolostomy and present seven cases treated at our hospital in which this was used. We present: a) three women, one underwent an urocolostomy as a result of a myelomeningocele with urinary and fecal incontinence, another because of a pelvic malignancy, and the third after developing a post radiotherapy cysto-proctitis; b) four men, one underwent this surgical procedure as a result of a traumatic paraplegia with multiple urinary fistulae and neurogenic bladder, the other three were secondary to pelvic malignancies (two bladder and one sigmoid malignacies). The outcome was fine in all cases with no pyelonephritis or metabolic imbalances; in all cases it represented a good option for these patients.

Adult↗
PubMed2003

[Emphysematous pyelonephritis: report of a case and review of the literature].

Emphysematous pyelonephritis is a necrotizing renal parenquima infection, which is diabetes mellitus related in almost all cases. This is life threatening and has a high mortality rates despite aggressive management. The most important thing in management is a high diagnostic suspicious and also a rapid treatment, which means nephrectomy. We expose a case giving especial importance to clinical and image diagnose as treatment and evolution. We also make a literature review trying to understand this entity and find pathways for its therapeutic management.

Adult↗
PubMed2003

[Metastasis of prostatic carcinoma to the urethra: report of a case].

Penile metastases from prostate carcinoma are uncommon events, much more in urethra and corpus spongiosum, we add a case to the preexisting literature. A patient with hormone resistant prostate cancer consults for haematuria and voiding difficulties. During TURP we observe tumors at the penile urethra which are resected and result to be prostate cancer metastases. Patient is fine and without voiding disturbance after 7 months of following. We think is an interesant case because there is few reports in literature.

Adenocarcinoma↗
PubMed2002

[Metabolic risk factors in calcium urolithiasis according to gender and age of the patients].

INTRODUCTION: Little information is available on the metabolic changes found in relation to gender and aging in patients with urolithiasis. In this study a comparison has been made of the metabolic profiles in men and women, in different groups of aging, with calcium-containing urinary stones in order to identify possibly significant differences. MATERIAL AND METHODS: In the past five years, a total of 500 patients with calcium-containing urinary stones, 226 male (45.2%) and 274 female (54.8%), have undergone comprehensive metabolic evaluation. The mean age was 47.4 years, with a range of 20 to 75 years. The patients was included in 3 groups: 151 patients aged 20-39 years, 255 patients aged 40-59 years and 94 patients aged 60-75 years. A comparison has been made of the frequency of metabolic changes, the urinary biochemical parameters and the supersaturation index (AP(CaOx)) between a group of men and a group of women and the different groups of aging. All patients carried out in an identical manner to metabolic diagnosis. The patients with morphologic and functional abnormalities were excluded. RESULTS: Hyperoxaluria, hyperuricosuria and hypocitraturia were more common in men than in women, whilst in women, hypercalciuria and a low urinary volume were more frequent with respect to men, though the differences in hypercalciuria were not statistically significant. Men excrete higher levels of calcium, phosphate, oxalate, uric acid and magnesium than women. On the other hand, women excrete higher levels of citrate than men. The AP(CaOx) index is significantly higher in men than in women. Hypercalciuria were more common in patients aged < 60 years, and low urinary volume were more frequent in patients aged < 40 years. Patients aged < 60 years excrete higher levels of calcium, phosphate and uric acid. The AP(CaOx) index is significantly higher in patients aged < 60 years. CONCLUSIONS: Differences were observed between the metabolic profiles of men and women, and in different groups of aging. Men and younger patients afford a metabolic profile of upper lithogenic risk compared with women and older patients; this is consistent with the upper reported prevalence of lithiasis and the upper tendency to recurrence in men and middle-age patients.

Adult↗
PubMed2002

[Penile adenoma: clinical case].

Penile melanoma is a very uncommon neoplasm, being reported less than 60 cases. Event yet it outlines not few doubts about its diagnosis and treatment, and in advanced stages represents a challenge for the future since it prognosis is awful at short time. In the present article, its presented a glans melanoma diagnosed and treated at our Service. We make a brief revision of the literature and some basic issues on the management of this entity when it's localized in penis, since in the cases in which it extends far from this organ is yet oncological field.

Aged↗
PubMed2002

[Multiple urinary lithiasis and nephrocalcinosis secondary to primary Sjögren syndrome].

A 39 year old women with a primary Sjögren syndrome (pSS) had bilateral and multiple nephrolithiasis and nephrocalcinosis due to distal renal tubular acidosis (dRTA), hypercalciuria and hypocitraturia. She had in serum positive antinuclear antibodies with mottled pattern 1/320, totals ENA, Anti-SSA/Ro 52, Anti-SSA/Ro 60 and Anti-SSB-La antibodies. Stones were removed with extracorporeal shock wave lithotripsy satisfactory and were composed of calcium phosphate and calcium oxalate. Metabolic abnormalities were resolved with potassium citrate and hydrochlorothiazide. At two years of follow-up, the patient hadn't stone recurrence and had normal 24-hour urinary levels of citrate and calcium.

Adult↗
PubMed2002

[Bladder metastasis of a stomach carcinoma. Presentation of a case].

Metastatic tumors account for a small percentage within bladder neoplastic pathology. The presence of signs of bladder neoplasm in a patient with malignancies in other location must aware us about its metastatic origin. One of the most frequent locations of the primary tumor is the stomach. Its evolution is always bad. We present a case of a woman who previously had undergone surgery for a gastric carcinoma, and later suffered a metastatic bladder affectation. We make special attention in the clinic presentation, very similar to the typical transitional cell carcinoma, its anatomopathological diagnosis after transurethral resection (T.U.R.), and its evolution. We make a brief revision of the bladder metastatic pathology.

Adenocarcinoma↗
PubMed2002

[Typical renal metanephric adenoma. Conservative surgery].

Metanephric Adenoma is uncommon renal tumor included in the complex group of the embryologics or nefroblastics renal tumors. Generally occurs in young females and usually has excellent prognosis. It's important to differentiate of malignant variants, particularly renal cell papillary carcinoma, metanephric adenosarcoma and adult Wilms tumor. The suspicion and intraoperative analysis of the tumor can to facilitate the use of conservative renal surgery in order to avoid unnecessary radical and aggressive surgery. To exist cases of metastatic metanephric adenoma, and the totally benign characteristic of the metanephric adenoma and the malignant potential isn't totally clarify.

Adenoma↗
PubMedDate not supplied

[Surgical management of renal cell carcinoma with vena cava-right atrium thrombus].

Historically the presence of a thrombus in vena cava was associated with worse prognosis in patients with renal cell carcinoma, and the effective of surgery limited. However a extensive tumor thrombi can be present without evidence of lymph node and distant metastasis, an aggressive surgical approach with curative intent is justified. We retrospectively reviewed 25 patients with renal cell carcinoma and thrombus in vena cava and they underwent radical nephrectomy and thrombectomy. The IRM allowed to know the level of the thrombus into vena cava in all patients: 56% level I, 8% level II, 26% level III. There were 14 pT3b, 8 pT3c, 3 pT4, and 48% N+. The rate of complications was 36% and there were 4 perioperative death (16%). Patients without lymph node and no distant metastasis had a mean survival of 64% 46%, 37% to 2, 3, 4 years respectively. Patients with lymph node invasive an distant metastasis the prognosis was poor. We no noted correlation between level thrombus and prognosis.

Adult↗