Relevancia del antecedente de absceso perirrenal en pacientes sometidos a nefrectomía simple retroperitoneal

Published on Dec 1, 2018in Urología Colombiana
· DOI :10.1055/S-0038-1656555
Luis Daniel Carrillo-Córdova1
Estimated H-index: 1
(HGM: Hospital General de México),
Roberto Carlos Sarabia-Estrada (HGM: Hospital General de México)+ 11 AuthorsMateo Leopoldo Garduño-Arteaga1
Estimated H-index: 1
(HGM: Hospital General de México)
Sources
Abstract
Antecedentes  Las infecciones supurativas del rinon y del espacio peri nefritico son poco comunes. La nefrectomia simple consiste en extraer el rinon contenido dentro de la fascia de Gerota, tecnica usada principalmente para padecimientos no malignos del rinon. Ese termino puede ser potencialmente enganoso ya que el termino “simple” implica que la cirugia para enfermedad benigna, es tecnicamente menos desafiante con menos complicaciones en relacion a su contra parte: la nefrectomia radical. Metodologia  Se analizaron 58 pacientes. Los parametros demograficos de los pacientes con antecedente de absceso perirrenal, fueron comparados con los pacientes sin antecedente de absceso (Edad, genero, peso, localizacion del lito) variables transoperatorias (tiempo quirurgico, sangrado transoperatorio) y variables postquirurgicas (necesidad de terapia intensiva, necesidad de transfusion, infeccion de herida quirurgica y dias de estancia hospitalaria). Resultados  Los pacientes se dividieron en dos grupos, los que contaban con antecedente de absceso (Grupo 1), y aquellos que no tenian antecedente de absceso (Grupo 2). Se encontraron veinte pacientes con antecedente de absceso (34,55%) y treinta y ocho sin antecedente de absceso (65,6%). Al realizar la comparacion entre los dos grupos se encontraron con mayor frecuencia en el grupo diferencias estadisticamente significativas para las variables de tiempo quirurgico (212 minuto (DE 46,6) vs 130.3 minuto (DE 49) p  = 0.0001), dias de estancia hospitalaria (8,6 dias (DE 4,1) vs 5,6 dias (DE 1.9) p  = 0.0003), e infeccion de herida quirurgica (70% vs 31% p  = 0,0008), no existieron diferencias estadisticamente significativas para el sangrado transoperatorio, necesidad de transfusion o necesidad de atencion en unidad de cuidados intensivos. Conclusiones  La realizacion de una nefrectomia retroperitoneal simple abierta secundaria a litiasis en pacientes con antecedente de absceso perirrenal, conlleva a un mayor tiempo quirurgico, secundario a una mayor dificultad tecnica del procedimiento, por la gran cantidad de fibrosis y destruccion de la anatomia producida por el absceso. Los pacientes, tambien presentan un riesgo aumentado de infeccion de la herida quirurgica, lo que conlleva a una mayor estancia hospitalaria y a una mayor inversion de recursos materiales y humanos.
References12
Newest
#1Bachar Zelhof (Central Manchester University Hospitals NHS Foundation Trust)H-Index: 1
#2Iain G. McIntyre (Central Manchester University Hospitals NHS Foundation Trust)H-Index: 1
Last. Ben R. Grey (Central Manchester University Hospitals NHS Foundation Trust)H-Index: 1
view all 6 authors...
Objective To summarize the practice of UK urologists with regard to nephrectomy for benign disease, documenting the indications, procedural techniques and outcomes. Methods All patients undergoing nephrectomy for a benign condition in 2012 were identified from the British Association of Urological Surgeons (BAUS) nephrectomy database. Recorded variables included the technique of surgery, the type of minimally invasive procedure, operating time, blood loss, transfusion rate, conversion rate, intr...
13 CitationsSource
#1John M. Henderson (Southmead Hospital)H-Index: 1
#2Sarah FowlerH-Index: 11
Last. Baus (Southmead Hospital)H-Index: 1
view all 5 authors...
Objective To present the perioperative outcomes from the British Association of Urological Surgeons (BAUS) nephrectomy dataset for 2012, the first year of public reporting of individual surgeon outcomes in the UK. Patients and Methods All nephrectomies performed in the year 2012 and recorded in the database were analysed. These were divided into simple nephrectomy (SN), partial nephrectomy (PN), radical nephrectomy (RN), and nephroureterectomy (NU). The estimated capture rate for nephrectomy was...
23 CitationsSource
#1Abdulkadir TepelerH-Index: 23
#2Tolga AkmanH-Index: 26
Last. Ahmet Tefekli (Koç University)H-Index: 30
view all 7 authors...
Laparoscopic nephrectomy has become the gold standard procedure for nonfunctioning or symptomatic benign kidneys due to renal calculi, obstructive, refluxive, and inflammatory nephropathies or renovascular hypertension. We aimed to investigate the effect of renal calculi as a reason of non-functioning on the progress and complication rates of the retroperitoneoscopic nephrectomy (RPN).During a 2-year period, 108 patients with benign renal conditions underwent RPN by single surgeon. Among these p...
17 CitationsSource
#1S. S. Connolly (Boston Children's Hospital)H-Index: 2
#2M. Frank O’Brien (Boston Children's Hospital)H-Index: 1
Last. Ronald Grainger (Boston Children's Hospital)H-Index: 17
view all 7 authors...
Background The Oxford English dictionary defines the term “simple” as “easily done” and “uncomplicated”. We tested the validity of this terminology in relation to open nephrectomy surgery.
3 CitationsSource
#1Jay D. Raman (Penn State Milton S. Hershey Medical Center)H-Index: 68
#2Prasanna Sooriakumaran (Penn State Milton S. Hershey Medical Center)H-Index: 29
Last. Abhay Rane (Penn State Milton S. Hershey Medical Center)H-Index: 25
view all 4 authors...
3 CitationsSource
#1RS RaiH-Index: 1
#2SC KaranH-Index: 1
Last. A KayasthaH-Index: 1
view all 3 authors...
Background This study was carried out to assess the spectrum of renal and perinephric space infection among urology patients admitted in the last three years.
8 CitationsSource
#1Daniel DindoH-Index: 23
#2Nicolas DemartinesH-Index: 64
Last. Pierre-Alain ClavienH-Index: 121
view all 3 authors...
Growing demand for health care, rising costs, constrained resources, and evidence of variations in clinical practice have triggered interest in measuring and improving the quality of health care delivery. For a valuable quality assessment, relevant data on outcome must be obtained in a standardized and reproducible manner to allow comparison among different centers, between different therapies and within a center over time.1–3 Objective and reliable outcome data are increasingly requested by pat...
17.4k CitationsSource
#1Maxwell V. Meng (UCSF: University of California, San Francisco)H-Index: 60
#2Layla A. Mario (UCSF: University of California, San Francisco)H-Index: 6
Last. Jack W. McAninch (UCSF: University of California, San Francisco)H-Index: 93
view all 3 authors...
ABSTRACTPurpose: We characterize the treatment and outcomes of perinephric abscesses in a contemporary cohort of patients.Materials and Methods: We reviewed the experience with perinephric abscesses at a single community based hospital. Abdominal computerized tomography (CT) was widely available during the study period and experience with radiographic guided percutaneous drainage was extensive. Therapy and intervention for individual patients were dictated by the treating physician.Results: Of t...
114 CitationsSource
#1David Hung-Tsang Yen (NYMU: National Yang-Ming University)H-Index: 23
#2Sheng-Chuan HuH-Index: 8
Last. Chen-Hsen Lee (NYMU: National Yang-Ming University)H-Index: 49
view all 7 authors...
The purpose of this study was to identify initial clinical characteristics that can lead to early diagnosis of renal abscess in the emergency department and predict poor prognosis. A retrospective review of 88 renal abscess patients, from April 1979 through January 1996, was conducted. Patients were categorized into two groups. In group 1, renal abscess was diagnosed by an emergency physician, whereas in group 2 renal abscess was not diagnosed by an emergency physician. Clinical characteristics ...
39 CitationsSource
#1Alexander Greenstein (Tel Aviv Sourasky Medical Center)H-Index: 41
#2Issac Kaver (Tel Aviv Sourasky Medical Center)H-Index: 11
Last. Haim Matzkin (Tel Aviv Sourasky Medical Center)H-Index: 29
view all 4 authors...
Objectives. To determine whether patients with nephrostomy after simple nephrectomy more often had postoperative wound complication than did matched patients without nephrostomy. Methods. The hospital records of patients who underwent retroperitoneal simple nephrectomy were evaluated, and the following data were retrieved: age, indication for nephrectomy and nephrostomy insertion, medical history, urine culture, antibiotic regimen, time elapsed from nephrostomy insertion to nephrectomy, surgical...
10 CitationsSource
Cited By0
Newest