The use of dynamic sentinel node biopsy in case of penile cancer. A case report

Penile cancer is a rare disease with prevalence of approximately 1/100000 man in Europe. Well documented risk factors for a penile cancer are HPV Infection, phimosis, and chronic inflammation. Penile cancer is a curable condition when diagnosed and treated promptly. The invasion of lymphatic system is one of the most important matters affecting long term survival. Proper evaluation and treatment of lymph nodes is a main goal when dealing with this condition. In patients with palpable lymph nodes lymphadenectomy is method of choice. When dealing with unpalpable lymph nodes and increased risk of micro-metastatic disease, invasive nodal staging is recommended. For this staging we can choose from Modified inguinal lymphadenectomy and Dynamic Sentinel Node Biopsy In this paper we would like to present a case report of patient with penile cancer, where due to TNM staging, Dynamic Sentinel Node Biopsy was implemented

Urinary bladder cancer – epidemiology, diagnostics and treatment in XXIst century

Urinary bladder cancer is one of the most common cancers occurring in those aged older, especially between 60 and 80 years of age. In Poland, it is the fourth (after lung, prostate, and colon cancers) on/in the incidence of cancer in men and thirteenth in women. Epidemiological indicators of bladder cancer in Poland are disturbing to other European countries, where a decrease is observed in both morbidity and mortality. In the years 1991-2006 in Poland a very dynamic increase in the incidence of bladder cancer (reaching 59%) was recorded. What's more, our country ranks second, after Spain, in Europe in terms of mortality from this cancer. In the coming years the number of cases and deaths from bladder cancer in Poland is expected to increase. This article discusses new information/data on the epidemiology, methods of diagnosis and treatment of patients with bladder cancer

Ocena powikłań po operacjach laparoskopowych nowotworów nerek wg klasyfikacji Clavien-Dindo

Wstęp: Zabiegi chirurgiczne są uznaną, podstawową metodą leczenia nowotworów złośliwych nerek. Cel: Celem pracy była ocena powikłań pooperacyjnych wg klasyfikacji Clavien-Dindo po zabiegach laparoskopowych w przebiegu leczenia nowotworów złośliwych nerek. Materiał i metody: Badaniem retrospektywnym objęto 112 chorych. Badania oparto o analizę danych z dokumentacji medycznej kliniki oraz dokumentacji poradni urologicznej. Klasyfikację powikłań pooperacyjnych wg Claviena i Dindo u operowanych oceniono w 7-stopniowej skali. Wyniki: Powikłania o mniejszym nasileniu wystąpiły u 24 (21,4%) pacjentów. Wszystkie w/w powikłania opanowano w sposób zachowawczy podażą leków i przetaczaniem krwi. Powikłanie w stopniu IIIb wystąpiło u 1 (0,9%) pacjenta i wymagało usunięcia nerki. Wnioski: Zastosowanie klasyfikacji Clavien-Dindo w ocenie powikłań pooperacyjnych zabiegów laparoskopowych na nerce jest prostym i obiektywnym narzędziem diagnostycznym stanu pooperacyjnego chorych. Uzyskane wyniki przeprowadzonego przez nas badania oceny powikłań po operacjach laparoskopowych nerek wg klasyfikacji Clavien-Dindo są zbliżone do wyników uzyskanych w renomowanych ośrodkach urologicznych

Assessment of complications after laparoscopic surgery of kidney tumors using Clavien-Dindo classification

Introduction: Surgical procedures are accepted, basic method of treating kidney cancer. Aim: The aim of the study was to assess postoperative complications according to the Clavien-Dindo classification after laparoscopic procedures in the treatment of kidney cancer. Material and methods: A retrospective study involved 112 patients. The research was based on the analysis of data from the medical records of the clinic and the documentation of the urological polyclinic. Classification of postoperative complications according to Clavien and Dindo in the operated patients was assessed on a 7-point scale. Results: Less severe complications occurred in 24 patients (21.4%). All the above-mentioned TNMtransfusions. Grade IIIb complication occurred in one patient (0.9%) and required kidney removal. Conclusions: The use of the Clavien-Dindo classification in the assessment of postoperative complications of laparoscopic renal procedures is a simple and objective diagnostic tool for establishing the postoperative condition of patients. The results of our examination of complications after laparoscopic renal surgery according to the Clavien-Dindo classifications are similar to those obtained in renowned urological centers

Original paper <br> Estimation of testis volume in patients with varicocele treated by laparoscopic operation

Introduction: Seminal cord varices cause degenerative processes in testicles described as “orchidopathia e varicocele”. One of the coefficients of surgical treatment efficacy could be an increase of the testicle volume after surgical procedure. Material and methods: In 83 patients operated due to left side seminal cord varices the ultrasound examination of scrotum was performed aiming, among others, at the evaluation of both testicles volume. The examination was performed before the surgical procedure and then in the period of 6-8 months after the laparoscopically performed surgical procedure. The ultrasound examination was made by means of sector head (frequency of 7.5 MHz) and the examination unit B&K Medical 3535. During the examination the patient was in standing position. The testicle volume (in cm3) was calculated by means of urological measurement module, which was the part of ultrasound examination unit software. Results: In the patients with seminal cord varices a statistically significant increase of the left testicle volume after applied laparoscopical surgery treatment was gained (p<0.001). The increase of the left testicle volume was found in 71 of 83 operated patients. Conclusions: 1. The application of the laparoscopic method in the patients with left seminal cord varices causes an increase of the testicle volume on the operated side. 2. The ultrasound evaluation of the testicle volume is safe for the patient and simple for the physician diagnostic method

Results of surgical treatment of kidney cancer in the Department of Urology, Medical University of Lodz in 2004–2010

Introduction. Aim of the study: The only effective treatment method for all forms of the kidney cancer is surgery with possible subsequent institution of neoadjuvant treatment. The standard management involves nephrectomy with or without lymphadenectomy and adrenalectomy. In patients with kidney tumors up to 4 cm in diameter, surgical procedures saving the renal parenchyma (Nephron-Sparing Surgery – NSS) are currently performed. The objective was the retrospective analysis of the treatment results obtained in renal cancer patients who had undergone surgical procedures. The results of the treatment following nephrectomy performed from transperitoneal and retroperitoneal approach were compared with those obtained after NSS type procedures. Material and methods: The study was carried out in 238 patients: 107 women and 131 men with kidney cancer, operated on in the years 2004 – 2010. In 15 patients distant metastases were found. The nephrectomy was performed in 69 patients from transperitoneal access and in 105 patients from retroperitoneal access with NSS procedures in 55 patients. The transperitoneal approach was used in patients with large tumors ranging > 6 cm size. Other patients were operated on with lumbar access, also those with tumors 10 cm during transperitoneal access surgery. The blood loss was compensated in 33 cases by the administration of RBC preparations in 21.74% of the patients after transperitoneal access surgeries and 10.65% of those after lumbar access. Retroperitoneal access was associated with the use of larger quantities of analgesic medications in the postoperative period. Histopathological investigations resulted with clear cell carcinoma in 85% of the patients, in other 15% of the cases, most commonly diagnosed with chromophobe and papillary carcinomas. The malignancy grade of RCC according to Fuhrman scale; Fuhrman 1 – 7.98%, Fuhrman 2 – 61.38%, Fuhrman 3 – 9.66%, Fuhrman 4 – 5.88%. Fuhrman grades 3 and 4 were, however, more common in the patients with the big tumors undergoing transperitoneal access. The local advancement of the removed kidney tumors according to TNM classification: stage pT1 in 156 patients, stage pT2 in 52 and pT3 in 1 patient. The distribution of diagnoses and staging was similar for both surgical approaches. The results of kidney cancer treatment were reflected by the assessment of 5–year survival of the patients. Such analysis was possible only in the subgroup of 115 patients who had undergone the surgery in the years 2004 – 2007. The obtained data indicated the overall 5–year survival rate amounting to 58.3% of the reviewed subgroup, whereas 48 patients, i.e. 41.7% died. The causes of death were not possible to know. It is noteworthy that the group of deaths included all the patients operated on at the metastatic stage of the disease. Conclusions: In large renal tumors > 6 cm size, transperitoneal access nephrectomy was preferred. In the remaining patients lumbar access procedures were performed, including kidney-sparing surgery. Fuhrman grade 3 and 4 clear cell tumors are predominant in the patients operated on with transperitoneal access. The number of intra- and postoperative complications is similar in both groups. The use of transperitoneal access is associated with an increase in the amount of analgesics administered in the postoperative course, longer duration of the surgical procedure and longer hospitalization time. The overall 5–year survival rate for the group of 115 patients operated on in the years 2004–2007 was 58.3%