Biomedical subjects

Luis Llanes González

Publications and source records attributed to Luis Llanes González.

6 recordsLinked to original sources

PubMed2005

[Diagnostic antegrade ureteroscopy of the upper urinary tract in the orthotopic neobladder].

OBJECTIVES: To demonstrate the usefulness of antegrade endoscopical examination in the evaluation of the upper urinary tract pathology in patients with orthotopic neobladder. METHODS/RESULTS: We present the technique of percutaneous antegrade ureteroscopy and the indications for treatment of the upper urinary tract urothelial tumor (radical or conservative) depending on multiple pyelo-calyceal biopsies and tumor lesions. CONCLUSIONS: Endoscopical evaluation of the upper urinary tract in patients with orthotopic neobladder offers safer information than urine analysis, urine cytology, and the various radiological tests. The difficulty for retrograde examination is on the identification of the ureteral neomeatus, so that in case of failure, antegrade percutaneous approach allows complete ureteral and pyelocalyceal examination and biopsies thanks to the development of flexible endoscopes. The information supplied by these endoscopical examinations of upper urinary tract urothelial tumors (grade, stage, multifocality) allows the choice of radical or conservative (open surgery or endoscopical) treatment.

Female↗

PubMed2005

[Penile prosthesis. Quality outcomes and morbidity].

OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 1993 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 +/- 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction). 23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation.

Humans↗

PubMed2005

[Spermatic cord rhabdomyosarcoma in an adult].

OBJECTIVES: To report one case of spermatic cord rabdomyosarcoma in an adult patient. METHODS: We report the case of a 36-year-old male presenting with a painful left inguinal scrotal mass. RESULTS: Left radical orchiectomy was performed with excision of the mass. Pathology showed a spermatic cord rabdomyosarcoma. The patient received several cycles of systemic chemotherapy. CONCLUSIONS: Spermatic cord rabdomyosarcoma is a rare tumor derived from the undifferentiated mesoderm. It rarely appears after the second decade of life. Local-regional recurrence after surgery is very frequent. There are adjuvant treatments, the indication and use of which couldn't be included in proper protocols due to the low incidence of this tumour in adults.

Adult↗

PubMed2005

[Stone Cone: a device that prevents ureteral stone migration during intracorporeal lithotripsy].

OBJECTIVES: Proximal migration of stone fragments during ureteroscopic lithotripsy is a common problem influenced by pressure of irrigation solution, type of energy for lithotripsy, site and degree of fixation of the stone to the ureteral wall, and degree of proximal ureteral dilation. The Stone Cone (Boston Scientific & Spencer) is a device that helps to prevent proximal migration of fragments and favours a safe extraction during ureteroscopic lithotripsy. TECHNIQUE: The Stone Cone is an helical device made of stainless steel and nitinol alloy, which consists of an internal guide wire and a sheath-like radiopaque catheter with a 3 Fr. calibre. Once the cone is placed above the stone it is maintained in that position during lithotripsy to avoid fragment migration. The external catheter is used to coil and unroll the cone, and allows access to place the cone above the stone. METHODS: We describe two cases of urinary calculi in the left lumbar ureter treated by ureteroscopy and intracorporeal lithotripsy with holmium YAG laser using the Stone Cone to avoid migration of fragments. RESULTS: One month after surgery no lithiasic fragments were observed in the imaging tests. CONCLUSIONS: The Stone Cone decreases the need to perform repeated ureteral instrumentations, and is also a safer and simpler method for the extraction of stone fragments. The use of Stone Cone seems to have more advantages than Dormia's basket during ureteroscopic lithotripsy in terms of lower incidence of residual fragments and reoperation rate.

Adult↗

PubMed2005

[Renal carcinoma and ipsilateral pheochromocytoma].

OBJECTIVES: To report one case of associated renal cancer and ipsilateral pheochromocytoma treated by laparoscopic surgery METHODS: We describe the case of a 67-year-old female presenting with left lumbar pain and recurrent urinary tract infections. Ultrasound and abdominal CT scan were performed revealing renal carcinoma and ipsilateral adrenal mass, which was confirmed by MRI. With the diagnosis of left renal carcinoma and possible adrenal metastasis, laparoscopic left nephrectomy and adrenalectomy were performed. RESULTS: Pathologic study of the specimen reported a chromophobic renal cell carcinoma and adrenal pheochromocytoma. CONCLUSIONS: The association of renal carcinoma and pheochromocytoma is unfrequent, as suggested by the limited available bibliography on the topic. The presence of an adrenal mass in a patient with history of primary tumor is frequently secondary to metastasic disease, although primary adrenal neoplasia should not be discarded.

Aged↗

PubMedDate not supplied

["Mini-percutaneous" percutaneous nephrolithotomy: technique and indications].

OBJECTIVES: Since Helal and Jackman developed the mini-percutaneous ("mini-perc") percutaneous nephrolithotomy (PCNL) for the treatment of pediatric renal lithiasis various authors have used is technique in adults with the aim to preserve renal parenchyma and diminish morbidity associated with the standard PCNL. METHODS: We describe the surgical technique of "mini-perc" PCNL in the treatment of renal lithiasis. RESULTS: We review various case series from the literature of "mini perc" PCNL for the treatment of adult renal lithiasis, its current indications, percentages of stone free patients, and associated problems, mainly the required instruments. CONCLUSIONS: Morbidity associated with "miniperc" PCNL seems to be lower than with the standard PCNL, but the use a smaller calibre tract with the only aim to preserve renal parenchyma does not offer advantages. It is a complementary technique to the standard PCNL; however, the diameter of the percutaneous access is not well defined yet and depends on the calibre of the instruments used.

Humans↗