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Biomedical subjects

J Estébanez Zarranz

Publications and source records attributed to J Estébanez Zarranz.

17 recordsLinked to original sources
PubMed2006

[Laparoscopic treatment of ovarian vein syndrome].

OBJECTIVE: We report a case of Ovarian Vein Syndrome, describe its clinical symptoms and discuss its diagnosis and management including laparoscopic surgery treatment. MATERIALS AND METHODS: A 36-year-old female with right kidney recurring pain was studied by means of abdominal RX, urography, CT, MRI and ultrasonography and finally diagnosed from Ovarian Vein Syndrome. The case was resolved with laparoscopic surgery. CONCLUSIONS: Ovarian Vein Syndrome is an uncommon disorder. Differential diagnosis must be done with external processes that cause ureteral obstruction. Surgery is the first line treatment when clinical symptoms are present and, in our opinion,laparoscopic surgery is the best approach to treat this pathology.

Adult↗
PubMed2003

[Laparoscopic radical prostatectomy. Preliminary experience].

OBJECTIVE: Laparoscopic technique has been developed with the aim to decrease the morbidity of the open radical prostatectomy. MATERIAL AND METHODS: From january 2002 to may 2002, 8 patients were treated for prostate cancer with laparoscopic radical prostatectomy. Unilateral linfadenectomy has been carried out in only one patient. We usually employ the transperitoneal technique published by the Montsouris Institute, with some modifications. RESULTS: The main surgical time was 356 minutes (540-240). Transfusion wasn't needed in any case. Intraoperative complications were: 2 bladder injuries, 1 bleeding of the epigastric artery. Postoperative complications were: 1 ileus, 2 compressive neurapraxia, 4 anastomotic fistutas. All complications were treated conservatively. No patient were converted to open surgery. Surgical limits were negatifs in all cases, and the PSA rate was less than 0.1 ng/ml in the first month follow up. CONCLUSION: Laparoscopic radical prostatectomy is a difficult technique, but we think that, the learning curve is getting lower and lower than in the first series. Oncologic results with this technique is similar to the open one. However, laparoscopic approach shows us some benefits such as less bleeding, less time catheterisation, less hospital stay, better continence, better sexual function, better stetic result, less postoperative pain, and finally an earlier back to work.

Aged↗
PubMed2002

Bacteriological conversion in twenty urinary tuberculosis patients treated with ofloxacin, rifampin and isoniazid: a 10-year follow-up study.

Twenty patients with urinary tuberculosis were treated with ofloxacin (200 mg/day, 6 months), rifampin (600 mg/day, 3 months) and isoniazid (300 mg/day, 3 months) between 1989 and 1990. All patients were new cases, diagnosed by observation and/or isolation of Mycobacterium tuberculosis in one of the three morning urine samples. Bacteriological culture conversion (negativization) was assessed as a clinical guide of efficacy, comparing it, as the only parameter, against a control group (150 patients) with urinary tuberculosis who received conventional therapy. Bacteriological follow-up studies were performed in both groups monthly for 6 months, then again 6 months later and then every year for 10 years after completion of treatment. In the 20 patients, the initial culture was positive with over 100 colonies per culture (>50%); the smear was positive in 45% of the patients (most were 2+). All strains were susceptible to rifampin, isoniazid and ofloxacin. Two patients discontinued treatment. Beginning with the first month of treatment, the bacteriological conversion was 100%, 89.5% and 100% in the remaining controls. In the control group, which received conventional treatment, the conversion was: 90%, 87%, 93% and 100% in the remaining controls. Treatment with ofloxacin resulted in a bacteriological conversion similar to that following conventional treatment ( p>0.05, Fisher's exact test). After 10 years of patient follow-up, we conclude that ofloxacin, in combination with rifampin and isoniazid (both for 3 months only is effective against M. tuberculosis, providing satisfactory bacteriological and clinical efficacy.

Adult↗
PubMed2001

[Quality of life in patients treated with orthotopic bladder substitution versus cutaneous ileostomy].

PURPOSE: Nowadays, psychcological and social aspects of treatment of urinary diversion after cystectomy, have become of utmost importance. Body image, potency, continence, emotional distress and dissatisfaction, functional and social activities are majors factors to improve quality of life after surgery. The aim of this study is to compare health-related quality of life after bladder substitution with ileal conduit diversion. MATERIALS AND METHODS: We developed a questionnaire based upon a literature review, to compare health related quality of life between bladder substitution and ileal conduit (45 multiple choice mailed questionnaire). We examined functional and social activities, sexual dysfunction, urinary problems, and body image dissatisfaction. RESULTS: 78 male patients with bladder cancer, were interviewed. 91% of the questionnaires were answered, 48.7% by patients' family and 42.3% by the patients themselves. 6 patients underwent ileal conduit and 27 underwent bladder substitution. Patients with ileal consuit presented higher body image dissatisfaction than those who underwent bladder substitution. When urine leakage occurred it caused more distress to the conduit patients, indicating urinary leakage as their main problem. Bladder substitution patients did not consider continence problems as very important, they had not interrupted social activities such as travelling or seeing friends. 100% of bladder substitution patients would not mind to undergo this operation again, while only 66% of ileal conduit patients would. CONCLUSION: Health-related quality of life is higher after bladder substitution. In our opinion we should use bladder substitution as the standard method of diversion after radical cystectomy for bladder cancer.

Adult↗
PubMed2000

[Ureteral stenosis of uretero-ileal anastomosis].

Replacement plasty allows to perform oncology surgery while maintaining body image and preserving renal function. Entero-ureteral anastomosis is a significant element in this procedure where the main responsible for the loss of renal function are stenosis, infection and reflux. Our group has performed 206 orthotopical vesical replacements (November 1981-November 1998), using a direct Wallace-type uretero-ileal anastomosis. An intussusception valve system was used as antireflux mechanism. The number of obstructions, rate of stenosis at the uretero-ileal junction and incidence of valve stenosis were all analyzed as part of the complications occurred over a follow-up period of 54 months (6-183). Findings included 6 stenosis at the uretero-intestinal junction and 2 at the intussusception valve. Two (3.8%) of the uretero-ileal stenosis were earlier and associated to fistula; one was treated with open surgery and one had a double J placed through antegrade percutaneous access. Of the remaining late four, only one was treated with a double J catheter while the other three had to be re-operated. Stenoses of the valvular system (1.2%) were solved with open surgery. From our experience, we believe that direct uretero-ileal implantation with scraping of the ureter is a safe technique with little risk for stenosis at the uretero-ileal junction. Intussusception was used a antireflux system in all cases.

Anastomosis, Surgical↗
PubMed2000

[Orthotopic substitutive cystoplasty in women. Technical modifications in anterior exenteration: results in 9 cases].

OBJECTIVE: The results obtained in 9 female patients who underwent bladder substitution after a modified anterior pelvic exenteration are presented. METHODS: From 1994 to 1999, 9 women underwent bladder substitution after a modified anterior pelvic exenteration that preserved the two distal thirds of the urethra, the pubourethral ligaments and endo-pelvic fascia and limited laterovaginal dissection to preserve the innervation of the striated sphincter for continence. RESULTS: The bladder capacity was 332.9 +/- 35.6 ml and urinary flow was 17.7 +/- 2.9 ml/sec. Seven patients are completely continent and two patients have stress incontinence grade II. None of the patients had difficulty with bladder emptying. Fistula (one case) and diarrhea (one case) were the most important complications. CONCLUSIONS: Our approach is based on a better understanding of the anatomical mechanisms of female continence and the viability of the remaining urethra from the oncologic perspective. This technique achieves a high level of patient satisfaction and quality of life.

Aged↗
PubMed1999

[Laparoscopic approach of Dielt's syndrome].

Dielt's syndrome is generally known as nephritic colic due to the dilation of the urinary tract that results from a renal ptosis. In spite of renal ptosis being a commonly seen occurrence, sometimes it can be the cause of a serious painful clinical manifestation. This paper presents one case successfully treated through laparoscopic nephropexy. It also includes a discussion on the various diagnostic and therapeutical techniques.

Adult↗
PubMed1999

[Primary abscess of the psoas. Report of a case].

Psoas abscess is an uncommon condition at the present time. The initial anodyne signs and symptoms make diagnosis difficult. It can be diagnosed and rated as primary when the origin is not found, or secondary when a focus for infection spreading is detected. Drainage either percutaneously or by open surgery, and antibiotic therapy are the choice treatment, achieving an important survival rate. This paper presents a new case of psoas abscess, including a revision of the diagnosis and treatment of this condition.

Adult↗
PubMed1998

[Testicular epidermoid cyst].

Epidermoid cysts are benign tumours that can affect testicles. Incidence is rare, having been described until now in less than 200 cases. Contribution of one study case of testicular epidermoid cyst and discussion of issues on histogenesis, ultrasound diagnosis and therapy approaches.

Adult↗
PubMed1997

[Agenesis of vas deferens and cystic fibrosis].

Congenital bilateral absence of vasa deferens appears in 6% of obstructive azoospermia, and 60-70% of these patients also have cystic fibrosis mutations. Unilateral aplasia or agenesia of vasa deferens occurs in less than 1% male individuals and some studies have found that up to 43% cases show mutations in the cystic fibrosis gen. We contribute four case reports of bilateral agenesia who were seen for infertility, all of which showed presence of mutation. In none of the two cases of unilateral agenesia, who consulted for vasectomy, a mutation in the cystic fibrosis gen was found. Patients with bilateral agenesia and their partners should be screened for cystic fibrosis, prior to spermatic microaspiration and assisted fecundation.

Adult↗
PubMed1992

[Why is intussusception an antireflux mechanism?].

One of the aims of bladder substitution or augmentation using the intestine is to preserve renal function. If reflux impairs renal function, an antireflux mechanism should be attempted. Direct ureteroileal reimplantation with spatulation of the ureter is safer and carries a lower risk of stenosis. The antireflux mechanism is created by ileoileal or ileocecal intussusception without involvement of the ureter. Thus we can diminish the risk of stenosis and reflux at the same time.

Humans↗
PubMed1992

[Ileal ureteroplasties].

When the ureter is extensively compromised, preservation of the kidney without recurring to external diversion may be attempted by a psoas bladder procedure, transureteroureterostomy, renal autotransplantation or ureteral substitution using the intestine. The first two are not always possible and transplantation is perhaps extremely disproportionate. We therefore recur to ureteral substitution using the intestine. Ureteral substitution may be partial or total, although it is recommended to preserve the upper segment of the lumbar ureter whenever possible. The procedure can be performed using the entire ileal segment with or without modelling to the appropriate thickness. Reducing the diameter of the ileal graft will enhance urine propulsion, reduce mucus secretion and improve antireflux dynamics. Nine cases of ureteral substitution are described herein. Treatment depended on the underlying pathology, extent of ureteral compromise and location. The techniques employed were ureteral substitution with or without modelling and ureteral substitution combined with a bladder repair procedure.

Follow-Up Studies↗
PubMed1989

[Bilateral pheochromocytoma].

We report a case of bilateral adrenal pheochromocytoma in a young, male patient who consulted for arterial hypertension. The adrenal tumors had been accurately diagnosed by abdominal ultrasonography and confirmed by CT. The incidence of bilateral involvement in pheochromocytoma is briefly discussed and the methods currently utilized for topographic localization of the tumor are described.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Tuberculosis and renal cancer].

The association of tuberculosis and renal adenocarcinoma is very uncommon. In general, the condition presents clinically, radiologically and biologically, as a tuberculosis while the diagnosis of renal carcinoma came as a pathoanatomical finding following nephrectomy. We contribute one case report of tuberculosis and renal adenocarcinoma in association that initially presented with tumoral signs and symptoms in a 34-year-old female patient. The patient, with no previous background, was later diagnosed TBC. A review is made on the pathogenesis, epidemiology and pathoanatomical diagnosis of tuberculosis. It is hypothesized that the tuberculosis damage may be a reactivation secondary to a renal tumour.

Adenocarcinoma, Clear Cell↗