Primer retroperitoneal tümörlü olguların analizi

WOS: 000464102400007Objective: Retroperitoneal tumors are rare and most of them arise from mesodermal or neuroectodermal tissues and residues of the embryonic urogenital body. Retroperitoneal malignant tumors are seen more often than benign lesions. Due to their anatomic location and slow growth, pain and neurological symptoms do not appear until later stages. In this article, we aim to present our experience in eight cases with primary retroperitoneal tumor. Methods: Eight patients who underwent retroperitoneal tumor excision between April 2009 and April 2016 were included in the study. Gender, age, patients' complaints, the location, type and size of the tumor, surgical techniques, and morbidity, recurrence, and mortality rates were evaluated. The mean follow-up period was 41.3 months. Results: Four of the eight patients were females and the mean age was 48.6 years. The retroperitoneal mass was located in the abdomen (n= 4) and in the pelvis (n= 4). In addition to abdominal pain, some patients experienced back and leg pain, difficult urination, and constipation. Intra-operative biopsy was performed previously during a laparotomy (n= 2). Mass excision was performed by open and laparoscopic surgery. Variable histopathological diagnoses were determined, such as schwannoma, cystic mesothelioma, angiomyolipoma, epidermoid cyst, liposarcoma, ganglioneuroma, and neurofibroma. Morbidity included intra-operative bleeding (n= 1), post-operative deep vein thrombosis (n= 2), and pulmonary embolism (n= 1). Postoperatively there were neither recurrences nor mortality. Conclusion: Primary retroperitoneal tumors can be located in different regions, but we did not find any tumors localized in the left lumbar region. The pathological diagnoses were heterogeneous, including seven benign lesions and one malignant lesion.Amaç: Retroperitoneal tümörler nadirdir ve çoğu mezodermal veya nöroektodermal kökenli olup ve embriyonik ürogenital cismin kalıntılarından kaynaklanmaktadır. Retroperitoneal malign tümörler benign lezyonlardan daha sık görülür. Anatomik yerleşimleri ve yavaş büyümeleri nedeniyle, ağrı ve nörolojik semptomlar gecikmiş aşamalara kadar görülmez. Bu yazıda primer retroperitoneal tümörlü sekiz olguluk deneyimimizi sunmayı amaçladık. Yöntemler: Nisan 2009-Nisan 2016 tarihleri arasında retroperitoneal tümör eksizyonu yapılan sekiz hasta çalışmaya dahil edildi. Cinsiyet, yaş, hastanın şikayetleri, yeri, tümör tipi ve boyutu, cerrahi teknikler, morbidite, nüks ve mortalite oranları değerlendirildi. Ortalama izlem süresi 41,3 ay idi. Bulgular: Sekiz hastadan dördü kadın, yaş ortalaması 48.6 idi. Retroperitoneal kitlelerin 4’ü batın (n=4) ve 4’ü pelvis (n=4) yerleşimliydi. Karın ağrısına ek olarak, bazı hastalarda sırt ve bacak ağrısı, zor idrara çıkma ve kabızlık şikayetleri tespit edilmiştir. Laparotomi öncesi intraoperatif biyopsi 2 hastada uygulandı. (n=2). Kitle eksizyonu açık ve laparoskopik cerrahi ile yapıldı. Schwannoma, kistik mezotelyoma, anjiomyolipom, epidermoid kist, liposarkom, ganglionöroma ve nörofibrom gibi değişken histopatolojik tanılar belirlendi. Hastaların dördünde intraoperatif (kanama (n=1), ameliyat sonrası derin ven trombozu (n=2) ve pulmoner emboli (n=1)) morbidite izlendi. Postoperatif dönemde rekürrens ya da mortalite izlenmedi. Sonuç: Primer retroperitoneal tümörler farklı bölgelerde yerleşebilmekle birlikte sol lumbar bölgede herhangi bir tümör lokalizasyonu izlenmedi. Yedi benign lezyon ve bir malign lezyon da dahil olmak üzere patolojik tanı heterojen olarak belirlendi

Laparoscopic Ureterolithotomy.

Background and Objective: The present study retrospectively analyzed the data of 213 patients who underwent laparoscopic ureterolithotomy

Flexible ureteroscopy versus laparoscopy for the treatment of patients who initially presented with obstructive pyelonephritis.

Objective: To compare the safety and effectiveness of flexible ureteroscopy (F-URS) with transperitoneal laparoscopic ureterolithotomy (TPLU) in cases of obstructive pyelonephritis secondary to large proximal ureteral stones

The impact of single positive surgical margin features on biochemical recurrence after robotic radical prostatectomy

ABSTRACT Objective: Parameters predictive of biochemical or clinical recurrence after Radical Prostatectomy (RP) were determined as pre-treatment PSA value, pathologic tumor stage, tumor grade and presence of Positive Surgical Margin (PSM), extracapsular extension and seminal vesicle invasion and the status of pelvic lymph nodes. The aim of our study is to evaluate the effect of additional features in patients undergoing RP in our clinic. Materials and Methods: We studied 556 RP operations performed between 2009 and 2016 for prostate cancer at this clinic. Preoperative and postoperative data of the patients were retrospectively reviewed. RP specimens were examined by two pathologists specialized in this subject. Of these patients, 78 (14.02%) patients with PSM were included in the study. The pathology slides of these patients were reassessed. The length of PSM (mm), localization (apex, basis and posterolateral) and Gleason pattern at this margin was determined and statistical correlations with BCR were calculated. Results: The mean follow-up after the RP of 41 patients included in the study was 37.4 ± 13.2 months. During the follow-up period of the patients, BCR was observed in 16 patients (39.02%). No statistically significant difference was observed in age and prostate volume between the groups with and without BCR development (p > 0.05). Preoperative PSA level was found to be statistically significantly higher in the group with BCR development compared to the group without recurrence (p = 0.004). In-group comparisons in each aforementioned Gleason score groups were performed in terms of BCR development and the preoperative Gleason score in the group with development of recurrence was found to be statistically significantly higher compared to the group without recurrence (p = 0.007). The length of the surgical margin was measured as 7.4 ± 4.4 mm in the BCR-developing group and 4.7 ± 3.8 mm in the no-BCR- developing group; it was statistically significantly higher in the group with development of recurrence (p = 0.03). Conclusion: Length and location of the PSM and the Gleason score detected in the PSM region could not predict biochemical recurrence according to the results of this present study. However high preoperative PSA value is an independent prognostic factor for biochemical recurrence