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Search Results: 1 - 10 of 198879 matches for " Aguilera Bazán "
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Cirugía conservadora de parénquima renal laparoscópica: Cinco a?os de experiencia
Aguilera Bazán,A.; Pérez Utrilla,M.; Girón de Francisco,M.; Reinoso Elbers,J.; Cisneros Ledo,J.; Pe?a Barthel,J. De la;
Actas Urológicas Espa?olas , 2010, DOI: 10.4321/S0210-48062010000300004
Abstract: introduction: laparoscopic nephron-sparing surgery is among the most complex urological procedures currently performed. open surgery continues to be the gold standard of care, but the laparoscopic approach is gaining ground slowly but surely. our 5 years′ experience is reported. materials and methods: from september 2004 to march 2009, 38 laparoscopic nephron-sparing procedures were performed at our hospital. a transperitoneal laparoscopic approach was used in all cases, with en bloc clamping of renal hilum in most patients. results: mean operating time was 141min, mean intraoperative bleeding 130ml, mean warm ischemia time 24min, and mean hospital stay 3.3 days. bleeding was the most common complication (requiring transfusion in 13.5% of patients). positive surgical margins were found in 5.4% of patients. conclusions: adequate selection of the patient (tumor size, location) and the procedure to be used, surgeon experience, and surgical skills are essential for achieving good oncological results and for minimizing the complications of this demanding procedure.
Nefrectomía radical laparoscopica: Técnica, resultados y complicaciones
Aguilera Bazán,Alfredo; Pérez Utrilla,Manuel; Girón,Manuel; Cisneros Ledo,Jesús; de la Pe?a Barthel,Javier;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000500012
Abstract: surgery is the treatment of choice for clear cell renal carcinoma not responding to chemotherapy, radiotherapy, or immunotherapy. the surgical procedure used has evolved over time in the past 40 years, mainly because of the development and widespread use of diagnostic procedures such as ultrasonography and ct. as a direct consequence, parenchymal-sparing surgery was no longer only used for patients with solitary kidneys and its indication started to be extended to patients with tumors up to 4 cm in diameter, in whom it has been shown to be a safe and effective alternative to radical nephrectomy. the other important milestone in development of renal cancer surgery undoubtedly was the revolution started in the 90s with advent of laparoscopic renal surgery, which has become established over the past 20 years approximately. laparoscopic surgery initially raised concern about oncological safety, but clinical series with sufficiently long follow-up times and large sample sizes are now available to consider the laparoscopic approach as a reliable procedure. technological development has caused the laparoscopic technique to be no longer seen as a procedure for the future, but rather as an absolutely current technique which should be implemented in most urology departments. implementation of any new procedure usually involves a number of complications which we should be prepared to assume, while making every effort to try and prevent them. it is therefore essential to develop, and to implement using common sense, a training program on the procedure. selection of patients and conditions to be treated is a crucial part of such a program.
Nefroureterectomía laparoscópica: nueva posición para el manejo ureteral
Aguilera Bazán,Alfredo; Alonso y Gregorio,Sergio; Pérez Utrilla,Manuel; Cansino Alcaide,Ramón; Cisneros Ledo,Jesús; Pe?a,Javier de la;
Archivos Espa?oles de Urología (Ed. impresa) , 2007, DOI: 10.4321/S0004-06142007000600009
Abstract: objectives: the main challenge of laparoscopic nephroureterectomy is the management of distal ureter, which also will have an important repercussion in the oncological outcome of many cases. we present our experience in such aspect, considering that we performed the last five laparoscopic nephroureterectomies in forced trendelemburg position, resulting in a more comfortable and safe management of the distal ureter. methods: between august and december 2006 we performed five purely laparoscopic nephroureterectomies with bladder cuff positioning the patient in forced trendelemburg, a position similar to that of laparoscopic radical cystectomy or prostatectomy. results: mean surgical time was 182 minutes (170-210). mean blood loss was 100 cc and no patient required transfusion. mean hospital stay was four days. conclusions: we believe this position is a good alternative for the management of the distal ureter during the laparoscopic approach. the technique is very similar to open surgery, which continues being the gold standard today.
Cirugía retroperitoneal laparoscópica: Experiencia del Hospital Universitario La Paz
Aguilera Bazán,A.; Pérez Utrilla,M.; Martín,M.; Pintado Otero,R.; Cisneros Ledo,J.; Pe?a Barthel,J. de la;
Archivos Espa?oles de Urología (Ed. impresa) , 2008, DOI: 10.4321/S0004-06142008000600009
Abstract: objectives: with the popularisation of laparoscopic radical prostatectomy, the above technique has once again taken on an important role in the work of urology departments. our extensive experience in laparoscopy means that we are performing increasingly more interventions using this approach. in the context of minimally invasive surgical procedures, this is probably bringing clearer benefits to retroperitoneal surgery than to prostatic surgery. in this article, we describe our series over nearly 4 years. methods: the period analysed covers june 2004 to march 2008, during which time 288 retroperitoneal operations were performed (184 nephrectomies, 113 other procedures). in the majority of cases, the route of approach was transperitoneal. results: the mean hospital stay was 3.6 days for the nephrectomies and 3 days for the other procedures. the transfusion rate for the nephrectomies was 5% and there was a conversion rate of in 2%. in the other types of surgery, the transfusion rate was 6% and there were no conversions. conclusions: the expansion of laparoscopy in urology has to be accompanied good patient selection and the progressive acquiring of experience on the part of the surgeon. certain interventions should only be tackled in cases where there is extensive experience.
Feocromocitoma: Tratamiento laparoscópico
Cabrera Castillo,Pedro Manuel; Aguilera Bazán,Alfredo; Cansino Alcaide,José Ramón; álvarez Maestro,Mario; Pe?a Barthel,Javier Jesús De la;
Archivos Espa?oles de Urología (Ed. impresa) , 2007, DOI: 10.4321/S0004-06142007000900015
Abstract: objective: we report this clinical case not only for the laparoscopic approach of a pheochromocytoma but also because of its particular aggressiveness and oddity of its clinical presentation. methods: 44 years old male presenting with oppressive chest pain with accompanying vegetative symptoms, who was diagnosed of right adrenal pheochromocytoma. results: after the diagnosis of pheochromocytoma was established and double adrenergic blockage implemented, transperitoneal laparoscopic surgery was performed. pathological analysis of the surgical specimen confirmed the clinical diagnosis of pheochromocytoma. patient was discharged home two days after surgery without any complication. conclusions: the laparoscopic approach of adrenal pheochromocytoma is possible and safe in centres with laparoscopic experience, obtaining the same results than open surgery, offering advantages for the patient such as less pain, smaller incisions, and early ambulation, which results in a shorter hospital stay.
A Review of Penile Cancer
A. Rando Sous,M. Pérez-Utrilla Pérez,A. Aguilera Bazán,A. Tabernero Gomez,J. Cisneros Ledo,J. De la Pe a Barthel
Advances in Urology , 2009, DOI: 10.1155/2009/415062
Abstract: Cancer of the penis is a rare tumour in Europe and mainly affects the elderly patient population. The aim of this paper was to analyse and study the characteristics of this tumour, in our patient population. Materials and Methods. A retrospective study was conducted on penile tumours diagnosed and treated in the Urology Department of the Hospital Universitario La Paz, Madrid, in the last ten years. Results. A total of 34 patients were diagnosed and treated. The mean age at presentation was 71.27 years. The mean time between symptoms and the first consultation was 12.54 months with a median of 6 months. The most common form of presentation was balanoposthitis (32%) and the most common site in our series was the glans. Partial penectomy was performed in 22 cases, total amputation in 8, and local excision in 3. Discussion. Carcinoma of the penis is a pathology which mostly affects elderly patients; in our series, the highest incidence was observed in patients in the group aged 75–84 years. The most common histological type was epidermoid carcinoma in its various forms of presentation. We recorded a mortality of 23%. Conclusion. Penile carcinoma is a rare pathology which affects elderly persons and is diagnosed late.
Suprarrenalectomía abierta y laparoscópica: Revisión de 10 a?os
Aguilera Bazán,A.; Pérez Utrilla,M.; Alonso y Gregorio,S.; Cansino Alcaide,R.; Cisneros Ledo,J.; Pe?a Barthel,J. De la;
Actas Urológicas Espa?olas , 2006, DOI: 10.4321/S0210-48062006001000009
Abstract: we present a 10 years open adrenalectomy review in our service and the beginning of laparoscopic adrenalectomy in the last year as a part of the retroperitoneal laparoscopic program at the hospital universitario la paz . the first laparoscopic adrenalectomy was done after 21 retroperitoneal laparoscopic surgeries. our initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
Cirugía retroperitoneal laparoscópica: experiencia de los 6 primeros meses del Hospital La Paz
Aguilera Bazán,A.; Alonso y Gregorio,S.; Cansino Alcaide,R.; Hidalgo Togores,L.; Cisneros Ledo,J.; Pe?a Barthel,J. de la;
Actas Urológicas Espa?olas , 2005, DOI: 10.4321/S0210-48062005000700004
Abstract: we present the initial results of retroperitoneal laparoscopic surgery in the hospital universitario la paz from july 2004 to december 2004. the program started after 2 years of pelvic laparoscopy surgery practice. the initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases.
Autotransplante renal laparoscópico experimental
Aguilera Bazán,A.; Murillo,S.; Benito de la Víbora,J.; Cisneros Ledo,J.; Pe?a Barthel,J. de la;
Actas Urológicas Espa?olas , 2004, DOI: 10.4321/S0210-48062004000100005
Abstract: laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. the technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. our main goal was to evaluate this technique as an experimental model for the vascular anastomosis, not to obtain a functional autotransplant. in this regard, here we summarize our experience during the first two cases performed.
Cirugía renal laparoscópica conservadora de parénquima: Experiencia inicial
Aguilera Bazán,A.; Alonso y Gregorio,S.; Pérez Utrilla,M.; Cansino Alcalde,J.R.; Cisneros Ledo,J.; De la Pe?a Barthel,J.;
Actas Urológicas Espa?olas , 2007, DOI: 10.4321/S0210-48062007000500006
Abstract: we present our initial experience in laparoscopic nephron sparing surgery. it's a technically advanced procedure requiring considerable minimally invasive expertise. this technique is particularly attractive compared to an open conventional procedure with its larger incision and associated morbidity.
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