Biomedical subjects

Gerardo Server Pastor

Publications and source records attributed to Gerardo Server Pastor.

6 recordsLinked to original sources

PubMed2004

[Fatal evolution of a renal angiosarcoma].

OBJECTIVES: Report a new case of renal angiosarcoma treated by surgery and adjuvant chemotherapy with bad results. METHODS: 72-year-old male undergoing right nephrectomy for renal tumor. Pathology reports renal angiosarcoma. RESULTS: Three months after surgery patient refers lumbar pain and hemoptysis and CT scan reveals the existence of multiple bone and lung metastasis; a regimen of systemic chemotherapy with Doxorrubicine+ Ifosfamide was started without response; he died two months later. CONCLUSIONS: Primary renal angiosarcoma is very rare, with less than 10 cases in the literature before 1998, and it is always associated with bad prognosis. Diagnosis is based on immunohistochemical studies (antibodies against CD31, CD34 and factor VIII related antigen) to define the endothelial differentiation of the tumor. There is no experience to define the best therapeutic strategy against this entity.

Aged↗

PubMed2004

[Hand-assisted laparoscopic radical nephrectomy vs. open nephrectomy in the treatment of clinically localized renal cell carcinoma. Comparative study].

INTRODUCTION: The description of the first laparoscopic nephrectomy made a revolution in the managing of the benign and malignant renal diseases. Hand-assisted laparoscopy (HAL) was developed with the aim of offering advantages to both patients and surgeons. The aim of the present work is to compare, in our experience, the results offered in the radical nephrectomy by HAL and open surgery, by analysis of surgical time, estimated blood loss during surgery and hospital stay. METHODS: Eleven Hand-assisted laparoscopic (HAL) radical nephrectomies and eight open radical nephrectomies were carried out at our institution during the same period (June 2001 to December 2002). All patients underwent computed tomography and were found to have a clinically localised functioning renal mass in all cases. The size of this renal mass was 4-7 cm (average 5.5 cm) in the HAL group and 4.5-15 cm (average 7.8 cm) in the open group. Patient age, body mass index, and American Society of Anaesthesiologists' score showed no significant difference between groups. RESULTS: The average surgical time in the HAL group was 156.72 minutes, the average blood loss during surgery was of 83.6 ml and the average hospital stay was of 3.09 days. Conversion to open surgery was not necessary in any patient. Average surgical time in the open surgery group was 178.25 minutes, the estimated blood loss during surgery was of 337.75 ml (p < 0.05) and the hospital stay was of 5.37 days (p < 0.05). The comparison of the means by two-tailed student's t test revealed significant differences in estimated blood loss and hospital stay, favoring HAL, and no significant differences in surgical time. CONCLUSIONS: HAL nephrectomy is feasible in almost all nephrectomies and is a safe, reproducible, and minimally invasive technique to perform extirpable renal surgery. HAL offer clear advantages over traditional open surgery, including decreased blood loss and hospital stay.

Carcinoma, Renal Cell↗

PubMed2003

[Relation between hypertension and clinical cases of benign prostatic hyperplasia].

OBJECTIVES: To confirm the relationship between hypertension and lower urinary tract symptoms (LUTS) in our environment, and to evaluate the association between hypertension and LUTS secondary to benign prostatic hypertrophy (BPH). METHODS: We prospectively studied during 3 months all male patients older than 50 years (163 patients) analysing previous medical history, IPSS, digital rectal examination, urine sediment, basic biochemical profile, PSA, uroflowmetry, and urinary tract ultrasound. Patients with neurological diseases, previous pelvic trauma, diabetes mellitus, suspicious digital rectal examination, abnormal PSA, or under treatment with alpha blockers, antidepressants, finasteride or antipsychotic drugs were excluded. RESULTS: From a total of 163 patients 113 were classified as suffering clinical BPH (LUTS, prostate greater than 30 gm, and uroflowmetry < 15 ml/sec), and 75 as hypertensive. Among 75 hypertensive patients 31 presented IPSS greater than 7 (41.3%) in comparison to 20 out of 88 non hypertensive patients (22.7%), being the difference statistically significant. CONCLUSIONS: Our study confirms what has been previously reported by other authors, that there is a statistically significant relationship between hypertension and LUTS secondary to BPH.

Aged↗

PubMed2003

[Magnetic resonance urogram as alternative to i.v. urography. Report of 3 cases. Review of the literature].

OBJECTIVES: Intravenous urography (IVU) has been classically considered as an essential examination in the great majority of urologic diseases due to the great amount of information that supplies both functional and morphological, mainly for ureteral abnormalities where other exams do not reach enough definition. Nevertheless, there are cases in which it is not possible to perform an intravenous urography due to allergy to iodine contrasts or renal failure with impossibility of contrast excretion. METHODS: We report three cases which represent the example of the indications of MRI urography as an alternative to IVU in cases in which this latter cannot or should not be performed. RESULTS: MRI urography is completely accepted as a diagnostic technique for urologic diseases as an alternative to IVU. It has advantages, such as obtaining images in multiple planes, avoiding the use of ionizing radiation, that there is no evidence of it causing cell damage, that it does not require glomerular elimination of any substance so it can be used in patients with renal failure and allergy to iodine contrasts. CONCLUSIONS: The use of MRI urography results in an advantage for patients with renal failure, iodine contrasts allergy, or greater risk of contrast nephrotoxicity as it is the case of renal transplant patients.

Adult↗

PubMedDate not supplied

[Controversies in the evaluation of asymptomatic microhematuria].

OBJECTIVE: Asymptomatic microhematuria continues to be a problem. It has a prevalence of 16% and numerous conditions can present this clinical manifestation. METHODS: A prospective study was carried out on all patients that consulted at the urological services during 2000 for asymptomatic hematuria. Patients presenting with irritative symptoms, urethral secretion, perineal or suprapubic pain, urinary tract infections, renal lithiasis or history of trauma were not included in the study. RESULTS: None of the patients presented tumors. Two patients presented renal lithiasis, 5 simple renal cysts, 8 hypercalciuria and 3 hyperuricosuria. None of the 11 patients with hypercalciuria or hyperuricosuria had a history of lithiasis. CONCLUSIONS: Although the size of the study is small, the incidence of tumors in patients with asymptomatic microhematuria appears to be far from the 12.5% incidence reported by some authors and might probably be closer to the 0.5% incidence reported by others. Furthermore, the significant pathology (renal lithiasis), which requires treatment, is also infrequent.

Calcium↗

PubMedDate not supplied

[Infiltrating bladder carcinoma and adrenal incidentaloma. Report of one case. Bibliographic review].

OBJECTIVES: We report one case of left adrenal tumor discovered during the study of an infiltrating bladder carcinoma. We discuss the diagnostic and therapeutic implications of the clinical case. METHODS: Surgical procedure was undertaken with radical cystectomy and Bricker's type urinary diversion, plus adenomectomy by anterior approach. RESULTS: The pathologic report showed a myelolipoma. CONCLUSIONS: Most adrenal tumors are benign, mainly if they are small and non-functioning. The protocol of hormonal study should include potassium and catecholamines. Tumors greater than 6 cm and functioning masses are indications for surgery. For oncological patients, surgical approach of the lesion is indicated if there is not evidence of dissemination.

Adrenal Gland Neoplasms↗