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L Alvarez Castelo

Publications and source records attributed to L Alvarez Castelo.

22 records · Page 2Linked to original sources
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↗
PubMedDate not supplied

[Marsupialization via minilaparotomy in the kidney transplant].

OBJECTIVE: To describe the results of treatment of posttransplant lymphoceles by marsupialization through a mini-laparotomy. METHODS: From March 1996 to May 1998, 7 patients with a symptomatic lymphocele that had not been resolved by conservative treatment with drainage and povidone-iodine sclerosis underwent internal marsupialization to the peritoneal cavity through a minilaparotomy. RESULTS: All patients showed a good postoperative course and were discharged two days after the procedure. Recent US scans of 5 patients showed a renal graft with a normal appearance and no perineal collections. Two patients had a recurrence; one of them was symptomatic and required another treatment. Drainage and povidone-iodine sclerosis resolved this condition. CONCLUSIONS: Marsupialization through a mini-laparotomy is an alternative to the laparoscopic approach and does not require new instruments or learning a new technique.

Adult↗
PubMedDate not supplied

[Value of PSA and (pre- postoperative) Gleason in predicting the potential lymphatic involvement in patients with prostatic cancer].

OBJECTIVE: To determine the possibility of selecting patients at risk for lymph node involvement prior to radical prostatectomy utilizing PSA concentration and/or the Gleason score. METHODS: We reviewed the records of 52 patients with tumor stage T1 to T3, who had undergone lymphadenectomy; of these, 50 patients underwent radical prostatectomy. The predictive values for PSA and the Gleason score and their utility in predicting risk of lymph node involvement were analyzed. RESULTS: Of the 52 patients, 10 (19%) had lymph node involvement. Nine of 26 patients (35%) with PSA > 20 and 9 of 21 patients (42%) with a Gleason score > 7 had lymph node involvement. No patient with PSA < 15 or Gleason score < 5 and none of the 24 patients (57%) with PSA < 20 and Gleason score < 7 had lymph node involvement. The preoperative biopsy was understaged in 21 patients (41%); of these, 16% had a Gleason score of 5-6. Two of these patients with PSA > 20 micrograms/ml had lymph node involvement. CONCLUSION: PSA concentration and the Gleason score are useful in predicting the risk of lymph node involvement. Patients with PSA < 20 and a Gleason score of < 7 can be considered to be at no risk and staging lymphadenectomy could be unnecessary. Although the preoperative Gleason score appears to have a predictive value, the possibility of understaging should be taken into account. In this regard PSA can be useful in identifying those patients at risk.

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