Journal of endourology
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The majority of patients with microscopic hematuria undergo a complete evaluation resulting in negative findings. The outcome of patients with hematuria was analyzed in an effort to optimize the use of investigations. ⋯ Patients with <5 RBCs/HPF on three urinalyses are unlikely to have significant pathology and could possibly be followed up conservatively. Patients < or =40 years of age should have a noncontrast CT or ultrasound study if they present with microscopic hematuria, and a cystoscopy should be added if gross hematuria exists. In older patients, a pre- and postcontrast CT and a cystoscopy should be performed.
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Journal of endourology · Jan 2008
Clinical TrialRenal hypothermia: experience in pigs and clinical trial.
This study was designed to compare the effectiveness of two methods of inducing renal hypothermia through laparoscopy in pigs and humans. ⋯ Induction of renal hypothermia using intracorporeal ice slush confers lower kidney temperatures than endoscopically-induced cold saline perfusion.
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Journal of endourology · Dec 2007
Comparative StudyPediatric laparoscopic pyeloplasty: 4-year experience.
Laparoscopic dismembered pyeloplasty for correction of ureteropelvic junction obstruction (UPJO) in the pediatric population is comparable to open dismembered pyeloplasty in success rates. Experience with this procedure however remains limited. We review our experience with this technique. ⋯ Our series of patients undergoing laparoscopic pyeloplasty had excellent results with low morbidity. We consider this our primary technique for surgical correction of UPJO in patients older than 18 months.
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Journal of endourology · Dec 2007
Case ReportsCase report: conservative management of a large capnothorax following laparoscopic renal surgery.
As indications for laparoscopy surgery continue to grow for management of upper urinary tract pathology, knowledge of the potential complications that may be encountered and their respective management are essential. Pneumothorax during laparoscopic renal surgery is typically related to a diaphragmatic injury that allows pressurized CO(2) to enter the thoracic cavity. ⋯ However, in selected patients, with understanding of the favorable absorptive properties of CO(2), conservative management may be elected. We report a case of an asymptomatic, large pneumothorax that was allowed to resolve spontaneously, thus reinforcing the notion of noninvasive capnothorax management incurred during laparoscopic renal surgery.
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Journal of endourology · Dec 2007
Case ReportsCase report: hand-assisted laparoscopic radical heminephrectomy for renal-cell carcinoma in a horseshoe kidney.
A 63-year-old woman with an incidentally detected 10-cm enhancing renal mass in the left moiety of a horseshoe kidney was treated with a transperitoneal hand-assisted laparoscopic (HAL) radical heminephrectomy. The operative time was 273 minutes, and estimated blood loss was 250 mL. To our knowledge, this is the initial case of HAL radical heminephrectomy for renal-cell carcinoma in a horseshoe kidney. Appropriate pre-operative imaging and surgical technique for the isthmusectomy are highlighted.