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R Rabii

Publications and source records attributed to R Rabii.

At least 37 records · Page 2Linked to original sources
PubMed2001

Experience with retroperitoneal laparoscopic adrenalectomy for pheochromocytoma.

PURPOSE: Although laparoscopic adrenalectomy has become the preferred surgical treatment of benign adrenal masses, for pheochromocytoma it is limited by concerns over hypertensive events related to early access to the adrenal vein. We report our experience with retroperitoneal laparoscopic adrenalectomy for pheochromocytoma. MATERIALS AND METHODS: From January 1995 to December 1999, 21 retroperitoneal laparoscopic adrenalectomies (left 12 and right 9) were performed for symptomatic pheochromocytoma in 11 men and 9 women 17 to 68 years old (mean age 46). To our knowledge pheochromocytoma was always diagnosed by increased urinary catecholamine, computerized tomography, magnetic resonance imaging and 131iodine iobenguane scintigraphy. RESULTS: There were no conversions to open surgery. The operating time ranged from 100 to 150 minutes (mean 116). Mean blood loss was 140 ml. (minimum 550), and none of the patients required transfusion. Hemorrhage due to adrenal vein injury occurred in 1 patient and was controlled intraoperatively. Average postoperative hospital stay was 3.4 days (range 1 to 12). The mean diameter of the excised masses was 38 mm. (range 15 to 70). Postoperative complications occurred in 4 cases, including hematoma in 1, trocar wound infections in 2 and eventration in 1 after 1 year. With a mean followup of 21.6 months (range 6 to 46), all patients had normal urinary catecholamine levels and 18 had normal blood pressure without treatment. CONCLUSIONS: Retroperitoneal laparoscopic adrenalectomy can be safely performed for small (less than 5 cm. diameter) pheochromocytoma. Retroperitoneal laparoscopy is a direct approach that allows the surgeon to control the adrenal vein first, thereby avoiding hypertensive events.

Adolescent↗
PubMed2001

[Treatment of pheochromocytomas with retroperitoneal laparoscopy].

OBJECTIVES: Although laparoscopic adrenalectomy has become one of the techniques of choice for the treatment of adrenal tumours, this technique has not been widely used to treat phaeochromocytoma due to the risks of hypertension before control of the adrenal vein. The authors report their experience of retroperitoneal laparoscopic adrenalectomy for phaeochromocytoma. MATERIAL AND METHODS: From January 1995 to December 1999, 10 (5 right, 5 left) retroperitoneal laparoscopic adrenalectomies were performed for symptomatic phaeochromocytoma, in 4 men and 6 women, aged 40 to 67 years (mean: 51 years). In every case, the phaeochromocytoma had been diagnosed by elevated urinary catecholamines, abdominopelvic CT scan and positive MIBG scintigraphy. RESULTS: There were no conversions to open surgery. The mean operating time was 116 minutes (range: 100 to 140 minutes). Mean blood loss was 180 ml (range: 0 to 550 ml) and none of the patients were transfused. In one case, an injury to the adrenal vein was repaired intraoperatively. The mean length of hospital stay was 3.4 days (range: 1 to 12 days). The mean diameter of the lesion was 38 mm (range: 15 to 110 mm). Postoperative complications occurred in two cases (one haematoma and one incisional hernia repaired one year later). With a mean follow-up of 21.6 months (range: 6 to 46 months), all patients had normal urinary catecholamine levels and 9 had a normal blood pressure with no antihypertensive therapy. CONCLUSION: Retroperitoneal laparoscopic adrenalectomy can be performed for small phaeochromocytomas (less than 5 cm). Retroperitoneal laparoscopy is a direct approach which allows the surgeon to control the adrenal vein first in order to avoid hypertensive crises.

Adrenal Gland Neoplasms↗
PubMed2001

[Seminal vesicle cyst associated with ipsilateral renal agenesis].

UNLABELLED: The seminal vesicle cyst associated with ipsilaterale renal agenesis is a rare entity. Through this case report, we analyse the clinical aspects, the importance of imaging techniques and the various therapeutic possibilities. The patient, age 24, presented perineal pain accentuated at ejaculation. The digital rectal examination showed a pre-rectal lump. Transrectal ultrasound plays an important role both for the diagnosis and the treatment. The treatment was perineal aspiration under transrectal echography control. The follow-up was satisfactory. CONCLUSION: The seminal cyst with ipsilareral renal agenesis is a rare congenital malformation, transrectal ultrasound is an excellent imaging technique for diagnosis, the perineal aspiration of the cyst constitutes a therapeutic alternative.

Adult↗
PubMed2000

Vesicourethral anastomosis during laparoscopic radical prostatectomy: the running suture method.

Vesicourethral reconstruction is the most critical and time-consuming step of laparoscopic radical prostatectomy. We describe the use of two hemicircumferential running sutures that has significantly simplified the procedure in our last 30 patients. The vesicourethral reconstruction took 31 minutes on average. Six months postoperatively, 84% of the patients were fully continent, and no bladder neck stenosis had occurred. The economy of intracorporeal suturing provided by this novel method, together with geometric factors such as the optimal position of the trocars, contributes to the improvement of ergonomy, allowing the surgeon to decrease operating times.

Anastomosis, Surgical↗
PubMed2000

[Pyonephrosis: diagnosis and treatment: report of 14 cases].

Prior to the introduction of antibiotics, the treatment of pyelonephrosis frequently consisted of nephrectomy to remove the non-functional kidney, which was a potentially dangerous source of systemic infection. This approach was later modified as a result of the advances made in antibiotic therapy, and included vigorous antibiotic treatment and prompt drainage of the kidney. At present, percutaneous nephrostomy provides a means of draining off the pus and determining a possible residual renal function. In this study, 14 cases of pyonephrosis were observed over a 7-month period. Lumbar pain was noted in 70% of cases, painful lumbar contact in 5 cases and fever, shivering and pyuria in all cases. Cytobacteriological urine analysis showed the presence of Escherichia coli in 7 patients, Proteus in 4 patients, and in 3 cases abacterial leucocyturia; in 2 patients with only one functional kidney, renal insufficiency was observed. In all cases, the diagnosis was confirmed by ultrasonography. The main etiological factors were urinary lithiasis in 10 patients (71%), followed by uropathy of the pyeloureteral junction in 4 patients (29%). Treatment consisted of primary nephrectomy in 10 cases; in 3 cases, primary nephrostomy was performed with a positive outcome and recovery of renal function in 2 subjects; in one case of renal failure treated by nephrostomy followed by conservative surgery, the patient did not survive. In conclusion, nephrectomy is advocated as the treatment of choice in the case of a damaged kidney and a normal contralateral kidney. Conservative treatment should be envisaged particularly in the case of a single kidney, or if the patient's state of health is poor. The best treatment consists of the detection and cure of the lithiasis which is the main etiological factor in this pathology.

Adult↗
PubMed2000

[Retroperitoneal sarcoma: report of 6 cases].

Retroperitoneal soft tissue sarcomas (RPS) are uncommon tumors. The diagnosis is frequently made later in the evolution of the disease due to the absence of specific symptomatology. Surgery with total resection of the tumor is the treatment of choice, but is only possible in 38 to 75% of cases. Six cases of RPS have been retrospectively reviewed; the mean time to diagnosis was 5 months; diagnosis was established via CT scan, which determined the retroperitoneal tumor location and its relationship to the neighboring organs. The most common symptoms were the presence of an abdominal mass and accompanying abdominal pain; signs of urinary and vascular compression were not found until later. Surgery with total resection was performed in 4 cases, and with partial resection in 2 cases. The histological findings were as follows: 3 liposarcomas, 2 rhabdomyosarcomas, and 1 fibrosarcoma. Tumor recurrence developed in 2 cases (liposarcomas), necessitating further surgery and complete resection. Two patients were lost to follow-up. RPS are characterized by locoregional relapse and metastases. Disease outcome depends on the histological type, tumor grade, and on the possibility of carrying out complete resection.

Adult↗
PubMed2000

[Fibrous pseudotumor of the vaginalis testis: report of a case].

In this study, the authors have reported a case of a benign fibrous pseudotumor of the tunica vaginalis testis in a 24-year old man who was admitted with a left scrotal mass. Scrotal ultrasound and surgical investigation demonstrated the presence of a left testicular tumor; radical orchiectomy was performed by inguinal route. Microscopic examination revealed a pseudotumor of the testicular tunica vaginalis. As this is an uncommon lesion and preoperative diagnosis is difficult, unnecessary radical orchidectomy is often carried out.

Adult↗
PubMed2000

[Isolated testicular tuberculosis: report of a case].

In this study, a case has been reported involving a 66-year old male who was admitted for scrotal pain on the right side with possible testicular involvement, but with no associated urinary disorder. At physical examination, the right testicle was found to have increased in volume: this was further confirmed by ultrasonography, but the findings were insufficient to exclude the hypothesis of testicular cancer. An exploratory orchidectomy by upper inguinal route was therefore carried out, and histopathological examination showed the destruction of testicular tissue by several granulomas, and caseous necrosis with giant cells. Antibacterial chemotherapy was administered after an i.v. urography found no evidence of abnormality or urinary disorder, thereby eliminating an active site of genitourinary tuberculosis. This case shows the importance of considering testicular tuberculosis in the differential diagnosis of testicular enlargement in a region where this disease is endemic, despite the absence of systemic pulmonary and urinary signs of tuberculosis.

Aged↗
PubMed2000

[Stab wound to the left solitary kidney: report of a case].

A forty-four-years old man with a left solitary kidney presented a stab wound in the left lumbar region. Upon admission, the patient was hemodynamically stable, the abdominal ultrasonography showed a small perirenal hematoma and the intravenous pyelography was normal. Two days later, he had no hematuria and was discharged from the hospital, with a computed tomography scan control two weeks later. Unfortunately, seven days later, the patient was admitted to emergency for left lumbar pain, a 40 degrees C fever and pyuria. The creatinine level was 72 ng/mL, and the computed tomography scan showed a large urohematoma. The patient was operated and required partial upper polar nephrectomy for distorted upper pole with infected hematoma. A large hematoma was removed and a nephrostomy tube was introduced. The renal function returned to normal six days postoperatively and the nephrostomy tube was removed after nephrostogram at 12 days. Concerning this uncommon case, we emphasize the advantage of the computed tomography scan and the necessity of emergency management in a patient with solitary traumatic kidney.

Abdominal Pain↗
PubMed2000

[Nephrectomy in a living donor by retroperitoneal laparoscopy or lomboscopy].

INTRODUCTION: The advantages of laparoscopic live donor nephrectomy are now well documented. This new approach can lower donor morbidity and could stimulate living related organ donation. We described our original operative technique and report our preliminary results. MATERIAL AND METHODS: Since 1998, we have used the retroperitoneal laparoscopy in tree related living donors. Advantages and inconvenient of this new surgical procedure were discussed with each donors and inform consent obtained. The left kidney was harvested in the three cases. RESULTS: The operative time was inferior to 280 minutes, warm ischemia less than five minutes and bleeding less than 150 mL. Patients were discharged between the 2nd and 3rd post-operative days. CONCLUSION: Retroperitoneal laparoscopy is a valuable alternative in transplant centres with skilled laparoscopic surgeons.

Humans↗
PubMed1999

[Pheochromocytoma. Report of 10 cases].

We report 10 cases of adrenal pheochromocytoma seen over a period 15-years. A female predominance was noted (8 women/2 men). Patients were aged between 16-46 years with a mean of 34 years. Clinical manifestations consisted of hypertension observed in all cases, with vasomotor symptoms (90%). Time to consultation was prolonged (mean: 23 months). CT scan performed in 7 cases showed pheochromocytoma in all cases, located on the right side in 6 cases, while one pheochromocytoma was located in Zukerkandal organ. All patients were operated via anterior approach and adrenalectomy was performed. A favourable course was observed in 90% of cases with normalisation blood pressure. One death was noted. Histological examination showed no malignancy in all cases.

Adolescent↗
PubMed1999

[Diagnostic and therapeutic problems of an atypical cyst of the kidney].

Atypical renal cyst raises diagnostic and therapeutic problems. The authors report a case of atypical renal cyst which raised numerous diagnostic and therapeutic problems. The authors discuss theses problems in the light of this case. A farmer consulted for right lumbar pain without hematuria and hydaturia. Hydatic serology was negative. Ultrasonography and CT scan showed atypical cyst in favour of hydatic cyst. Surgical investigations showed a necrotico-hemorragic cyst, and cystectomy was performed. Histological examination revealed a chronic inflammatory process without malignancy. One year after the operation, clinical and radiological examination were normal.

Humans↗
PubMed1999

[Peritonitis caused by spontaneous rupture of pyonephrosis in pregnancy. Report of a case].

Peritonitis after spontaneous rupture of pyonephrosis into the peritoneal cavity is a rare complication, usually diagnosed intraoperatively. We report a case of a woman presenting with left lumbar pain and fever during pregnancy. On admission, ultrasonography showed a pregnancy with fetal activity for 16 weeks, and pyonephrosis in the left kidney, but on a normal right kidney. After antibiotic therapy and upper urinary, tract stenting renal drainage revealed purulent urine, fever persisted with acute abdomen. Clinical and radiological assessment showed features of acute peritonitis with pyonephrosis. Treatment consisted of laparotomy with nephrectomy and abdominal lavage and drainage. The postoperative complication was septic shock requiring resuscitation and artificial ventilation and prolonged convalescence.

Female↗
PubMed1999

[Perineal recurrence of resected penile cancer. A case report].

The authors report an unusual case of perineal recurrence of squamous carcinoma of the penis in a 50-year-old, white man, circumcised during infancy and operated 5 years previously for stage T3N0M0 squamous carcinoma of the penis by total amputation of the penis. Clinical examination revealed a very large, infected perineal tumour associated with bilateral inguinal lymphadenopathy. This stage T4N2M0 tumour was treated palliatively by cystostomy, emasculation with perineal tumour reduction and antibiotics. The patient became afebrile and the infection resolved and was referred to the radiotherapy department for further treatment.

Anti-Bacterial Agents↗
PubMed1999

[Prostatic abscesses. A review].

We review the literature to the diagnosis and therapeutic aspect of prostatic abscess. The prostatic abscess having become an uncommon disease. The diagnosis of prostatic abscess has been nearly made by transrectal ultrasound and computed tomography scan. The best diagnostic method is considered to be the transrectal ultrasound. The choice therapy was intravenous antibiotic, and drainage by ultrasound guided transperineal percutaneous puncture.

Abscess↗
PubMed1999

[Renal leiomyoma. Case report].

The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

Diagnosis, Differential↗
PubMed1999

[Isolated bilateral adrenal metastasis from renal cancer. Case report].

The authors report an uncommon case of bilateral synchronous adrenal gland metastases from left renal cell carcinoma. The diagnosis was established by abdominal ultrasound and computed tomography. The surgical approach initially consisted of left radical nephrectomy and ipsilateral adrenalectomy. Histologically, the tumor of the left adrenal gland was identical to the left renal cell carcinoma. Subsequent contralateral adrenalectomy showed an adrenal metastasis identical to the left renal cell carcinoma. Patient follow-up was good with no recurrence of the disease after one year. This is an uncommon case for renal cancer. The treatment and prognosis are discussed.

Adrenal Gland Neoplasms↗