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Search Results: 1 - 10 of 301483 matches for " Luciano J.;Srougi "
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Non-Hodgkin lymphoma of the bladder
Antunes, Alberto A.;Nesrallah, Luciano J.;Srougi, Miguel;
International braz j urol , 2004, DOI: 10.1590/S1677-55382004000600009
Abstract: lymphomas of the bladder are rare lesions, representing approximately 0.2% of the primary neoplastic lesions and approximately 1.8% of the secondary lesions in this organ. the authors report the case of a 41-year old patient with secondary lymphoma of the bladder occurring 2 years after treatment for non-hodgkin lymphoma, diagnosed by biopsy of cervical lymph node, and analyze the clinical and prognostic aspects of bladder lymphomas.
Radical cystectomy with preservation of sexual function and urinary continence: description of a new technique
Miguel, Srougi;Dall'oglio, Marcos;Nesrallah, Luciano J;Arruda, Homero O;Ortiz, Valdemar;
International braz j urol , 2003, DOI: 10.1590/S1677-55382003000400010
Abstract: objective: to describe the original cystoprostatectomy technique which allows the preservation of sexual and urinary function in the majority of treated patients. surgical technique: the described technique presents some details that distinguish it from classic cystectomy: 1) a more efficient control of prostate venous and arterial tributaries; 2) preservation of prostatic capsule and enucleation of prostatic parenchyma, which is removed in block together with the bladder, without violating the vesical neck; 3) no manipulation of the distal urethral sphincteric complex; 4) preservation of seminal vesicles and maintenance of cavernous neurovascular bundles; 5) wide anastomosis between the ileal neobladder and the prostatic capsule. comments: the proposed maneuvers allow the performance of radical cystectomy with integral preservation of distal urethral sphincter and of cavernous neurovascular bundles, without jeopardizing the oncological principles.
Pathological extension of prostate cancer as defined by gleason score on biopsy
Dall'oglio, Marcos F.;Crippa, Alexandre;Paranhos, Mario;Nesrallah, Luciano J.;Leite, Katia R.;Srougi, Miguel;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000400005
Abstract: introduction: based on the importance of the gleason score on the behavior of prostate adenocarcinoma, this study attempts to predict the extension of prostate adenocarcinoma pre-operatively, as defined by the gleason score on biopsy, in individuals who will undergo radical prostatectomy. materials and methods: we selected 899 individuals who underwent retropubic radical prostatectomy from 1988 to 2004. clinical and pathological data obtained in the preoperative period were retrospectively analyzed through digital rectal examinations of the prostate, initial serum psa levels and pathological data provided by biopsy. the gleason score on biopsy was assessed and divided into 3 groups: 2 to 6, 7, and 8 to 10, and correlated with the possibility of the disease being confined to the prostate. results: from the 899 selected patients, 654 (74%) showed gleason scores of 2 to 6, 165 (18%) had a score of 7 and 80 (9%) had scores of 8 to 10 on biopsy. the likelihood of confined diseases, extraprostatic extensions, invasion of seminal vesicles and lymph nodal involvement were respectively: 74%, 18%, 8% and 0.8% for a gleason score of 2 to 6, 47%, 30%, 19% and 4% for a gleason score of 7, and 49%, 29%, 18% and 4% for a gleason score of 8 to 10. conclusion: in patients who will undergo radical prostatectomy due to prostate adenocarcinoma, a gleason score of 7 on biopsy shows the same behavior as a gleason score of 8 to 10 in relation to extension of disease.
The York-Mason technique for recto-urethral fistulas
Crippa, Alexandre;Dall'Oglio, Marcos F.;Nesrallah, Luciano J;Hasegawa, Endric;Antunes, Alberto Azoubel;Srougi, Miguel;
Clinics , 2007, DOI: 10.1590/S1807-59322007000600007
Abstract: objective: recto-urethral fistula formation following radical prostatectomy is an uncommon but potentially devastating event. there is no consensus in the literature regarding the treatment of these fistulas. we present here our experiences treating recto-urethral fistulas. material and methods: we analyzed 8 cases of rectourethral fistula treated at our institution in the last seven years. seven of the patients underwent repair of the fistula using the modified york-mason procedure. results: the causes of the fistula were radical retropubic prostatectomy in five patients, perineal debridement of fournier's gangrene in one, transvesical prostatectomy in one and transurethral resection of the prostate in the other patient. the most common clinical manifestation was fecaluria, present in 87.5% of the cases. the mean time elapsed between diagnosis and correction of the fistula was 29.6 (7-63) months. one spontaneous closure occurred after five months of delayed catheterization. urinary and retrograde urethrocystography indicated the site of the fistula in 71.4% of the cases. no patient presented recurrence of the fistula after its correction with the modified york-mason procedure. conclusion: the performance of routine colostomy and cystostomy is unnecessary. the technique described by york-mason permits easy access, reduces surgical and hospitalization times and presents low complication and morbidity rates when surgically correcting recto-urethral fistulas.
Radical cystectomy with preservation of sexual function and urinary continence: description of a new technique
Miguel Srougi,Dall'oglio Marcos,Nesrallah Luciano J,Arruda Homero O
International braz j urol , 2003,
Abstract: OBJECTIVE: To describe the original cystoprostatectomy technique which allows the preservation of sexual and urinary function in the majority of treated patients. SURGICAL TECHNIQUE: The described technique presents some details that distinguish it from classic cystectomy: 1) a more efficient control of prostate venous and arterial tributaries; 2) preservation of prostatic capsule and enucleation of prostatic parenchyma, which is removed in block together with the bladder, without violating the vesical neck; 3) no manipulation of the distal urethral sphincteric complex; 4) preservation of seminal vesicles and maintenance of cavernous neurovascular bundles; 5) wide anastomosis between the ileal neobladder and the prostatic capsule. COMMENTS: The proposed maneuvers allow the performance of radical cystectomy with integral preservation of distal urethral sphincter and of cavernous neurovascular bundles, without jeopardizing the oncological principles.
Preoperative determination of prostate cancer tumor volume: analysis through biopsy fragments
Antunes, Alberto A.;Srougi, Miguel;Dall'oglio, Marcos F.;Crippa, Alexandre;Nesrallah, Adriano J.;Nesrallah, Luciano J.;Leite, Katia R.;
International braz j urol , 2007, DOI: 10.1590/S1677-55382007000400004
Abstract: objective: preoperative determination of prostate cancer (pca) tumor volume (tv) is still a big challenge. we have assessed variables obtained in prostatic biopsy aiming at determining which is the best method to predict the tv in radical prostatectomy (rp) specimens. materials and methods: biopsy findings of 162 men with pca submitted to radical prostatectomy were revised. preoperative characteristics, such as psa, the percentage of positive fragments (ppf), the total percentage of cancer in the biopsy (tpc), the maximum percentage of cancer in a fragment (mpc), the presence of perineural invasion (pni) and the gleason score were correlated with postoperative surgical findings through an univariate analysis of a linear regression model. results: the tv correlated significantly to the ppf, tpc, mpc, psa and to the presence of pni (p < 0.001). however, the pearson correlation analysis test showed an r2 of only 24%, 12%, 17% and 9% for the ppf, tpc, mpc, and psa respectively. the combination of the ppf with the psa and the pni analysis showed to be a better model to predict the tv (r2 of 32.3%). the tv could be determined through the formula: volume = 1.108 + 0.203 x psa + 0.066 x ppf + 2.193 x pni. conclusions: the ppf seems to be better than the tpc and the mpc to predict the tv in the surgical specimen. due to the weak correlation between those variables and the tv, the psa and the presence of pni should be used together.
Survival of patients with prostate cancer and normal PSA levels treated by radical prostatectomy
Dall'oglio, Marcos F.;Crippa, Alexandre;Antunes, Alberto A.;Nesrallah, Luciano J.;Leite, Katia R.;Srougi, Miguel;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000300005
Abstract: introduction: the unpredictability of prostate cancer has become a daily challenge for the urologist, with different strategies being required to manage these cases. in this study, we report on the perspectives for curing prostate cancer in males undergoing radical prostatectomy with gleason score of 2-6 on prostate biopsy in relation to pre-operative psa levels. materials and methods: from 1991 - 2000, we selected 440 individuals whose pathological diagnosis revealed a gleason score of 2-6 upon prostate biopsy and who subsequently underwent retro-pubic radical prostatectomy due to localized prostate cancer. the clinical stage identified in the group under study was t1c: 206 (46.8%); t2a: 122 (27.7%); t2b: 93 (21.1%); t2c: 17 (3.9%); t3a: 2 (0.5%). following surgery, we constructed a biochemical recurrence-free survival curve according to pre-operative psa levels between 0-4; 4.1-10; 10.1-20 and > 20 ng/ml, with a median follow-up of 5 years. results: following radical prostatectomy, the pathological stage was confirmed as pt2a: 137 (31.1%); t2b: 118 (26.8%); t2c: 85 (19.3%); t3a: 67 (15.2%); t3b: 6 (1.4%); t3c: 22 (5%). the biochemical recurrence-free survival, according to psa values between 0-4; 4.1-10; 10.1-20 and > 20 ng/ml, was 86.6%, 62.7%, 39.8% and 24.8% respectively. conclusion: better chances for curing low-grade prostate cancer occur in individuals with normal psa for whom a biopsy is not usually recommended.
Deep-seated sarcomas of the penis
Antunes, Alberto A.;Nesrallah, Luciano J.;Goncalves, Pierre D.;Ferreira, Yuri A.;Campagnari, Joao C.;Srougi, Miguel;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000300008
Abstract: mesenchymal neoplasias represent 5% of tumors affecting the penis. due to the rarity of such tumors, there is no agreement concerning the best method for staging and managing these patients. sarcomas of the penis can be classified as deep-seated if they derive from the structures forming the spongy body and the cavernous bodies. superficial lesions are usually low-grade and show a small tendency towards distant metastasis. in contrast, deep-seated lesions usually show behavior that is more aggressive and have poorer prognosis. the authors report 3 cases of deep-seated primary sarcomas of the penis and review the literature on this rare and aggressive neoplasia.
Analysis of risk factors of involvement of seminal vesicles in patients with prostate cancer undergoing radical prostatectomy
Dall'Oglio, Marcos F.;Sant'Anna, Alexandre C.;Antunes, Alberto A.;Nesrallah, Luciano J.;Leite, Katia R.;Srougi, Miguel;
International braz j urol , 2004, DOI: 10.1590/S1677-55382004000600004
Abstract: objective: to determine through preoperative serum psa level, gleason score on biopsy and percentage of fragments affected by tumor on biopsy, the probability of involvement of the seminal vesicles. materials and methods: during the period between march 1991 to december 2002, we selected 899 patients undergoing radical prostatectomy for treatment of localized prostate adenocarcinoma. the analyzed preoperative variables were psa, percentage of positive fragments and gleason score on the biopsy. pre-operative psa was divided in scales from 0 to 4.0 ng/ml, 4.1 to 10 ng/ml, 10.1 to 20 ng/ml and > 20 ng/ml, gleason score was categorized in scales from 2 to 6. 7 and 8 to 10, and the percentage of affected fragments was divided in 0 to 25%, 25.1% to 50%, 50.1% to 75%, and 75.1% to 100%. all these variables were correlated with the involvement of seminal vesicles in the surgical specimen. results: of the 899 patients under study, approximately 11% (95% ci, [9% - 13%]) had involvement of seminal vesicles. on the multivariate analysis, when psa was < 4, the gleason score was 2 to 6, and less than 25% of fragments were involved on the biopsy, only 3.6%, 7.6% and 6.2% of patients respectively, had involvement of seminal vesicles. on the multivariate analysis, we observed that psa, gleason score and the percentage of involved fragments were independent prognostic factors for invasion of seminal vesicles. conclusion: the preoperative variables used in the present study allow the identification of men with minimal risk (lower than 5%) if involvement of seminal vesicles.
A new nomogram to predict pathologic outcome following radical prostatectomy
Crippa, Alexandre;Srougi, Miguel;Dall?Oglio, Marcos F.;Antunes, Alberto A.;Leite, Katia R.;Nesrallah, Luciano J.;Ortiz, Valdemar;
International braz j urol , 2006, DOI: 10.1590/S1677-55382006000200005
Abstract: objective: to develop a preoperative nomogram to predict pathologic outcome in patients submitted to radical prostatectomy for clinical localized prostate cancer. materials and methods: nine hundred and sixty patients with clinical stage t1 and t2 prostate cancer were evaluated following radical prostatectomy, and 898 were included in the study. following a multivariate analysis, nomograms were developed incorporating serum psa, biopsy gleason score, and percentage of positive biopsy cores in order to predict the risks of extraprostatic tumor extension, and seminal vesicle involvement. results: in univariate analysis there was a significant association between percentage of positive biopsy cores (p < 0.001), serum psa (p = 0.001) and biopsy gleason score (p < 0.001) with extraprostatic tumor extension. a similar pathologic outcome was seen among tumors with gleason score 7, and gleason score 8 to 10. in multivariate analysis, the 3 preoperative variables showed independent significance to predict tumor extension. this allowed the development of nomogram-1 (using gleason scores in 3 categories - 2 to 6, 7 and 8 to 10) and nomogram-2 (using gleason scores in 2 categories - 2 to 6 and 7 to 10) to predict disease extension based on these 3 parameters. in the validation analysis, 87% and 91.1% of the time the nomograms-1 and 2, correctly predicted the probability of a pathological stage to within 10% respectively. conclusion: incorporating percent of positive biopsy cores to a nomogram that includes preoperative serum psa and biopsy gleason score, can accurately predict the presence of extraprostatic disease extension in patients with clinical localized prostate cancer.
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