Navegando por Palavras-chave "Nephrectomy"

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    The boatman's knot: a new option for renal hilum ligation during laparoscopic nephrectomy
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2005-06-01) Bomfim, Alexandre C. [UNIFESP]; Andreoni, Cássio [UNIFESP]; Miotto, Ari [UNIFESP]; Araújo, Mardhen B. [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Poli de Figueiredo, Luiz Francisco [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: The authors present and describe an original adaptation for the use of boatman's knot in renal vein ligation during laparoscopic nephrectomy. This procedure may replace the need for the endovascular stapler, which is considered the standard of care, but not available in several institutions in Brazil. The knot presented is also known as thepig's knot in several farms in Brazil. METHODS: Fourteen laparoscopic nephrectomies were performed by the same surgeon in a standard fashion in seven female pigs. Both the renal artery and vein were ligated using the boatman's knot as the only method for hemostasis with conventional intracorporeal technique. Two knots were applied in each artery and vein; one knot was tied proximally and the other distally. The vessels were then sectioned in between both knots. This technique is based on the intracorporeal confection of two loops by the right hand pair of dissectors with the help of the left hand. The arteries and the veins were then sectioned and the capability to accomplish full hemostasis was observed. RESULTS: All the laparoscopic nephrectomies were performed successfully. The boatman's knot was performed by the same surgeon with neither complications nor difficulties during the confection of the knot. In all cases hemostasis was fully achieved using only the boatman's knot as the hemostatic method. CONCLUSION: The boatman's knot is feasible and safe for hilum control during laparoscopic nephrectomy in pigs and total hemostasis can be achieved using it as the only method of hemostasis. However, the safety and the capacity of others to learn how to apply it should be tested before it may be advised to use it routinely.
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    Brazilian data of renal cell carcinoma in a public university hospital
    (Brazilian soc urol, 2016) Aguiar Junior, Pedro [UNIFESP]; Padua, Tiago Costa [UNIFESP]; Guimaraes, Daiane Pereira [UNIFESP]
    Purpose: Among renal malignancies, renal cell carcinoma (RCC) accounts for 85% of cases. Stage is a relevant prognostic factor
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    Escore renal prático e intuitivo para planejamento cirúrgico e previsão de resultados no tratamento de tumores renais: uma nova ferramenta
    (Universidade Federal de São Paulo (UNIFESP), 2016-12-16) Santos, Matheus Tannus dos [UNIFESP]; Ribeiro, Cassio Andreoni [UNIFESP]; http://lattes.cnpq.br/2915020488175752; http://lattes.cnpq.br/9247109833611055; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Surgery continues to be the main form of treatment for renal tumors. Objective: Create a more practical and intuitive score for renal tumor classification. Methods: 80 patients underwent surgery for renal tumors and were prospectively enrolled. The tumors were classified using the following variables: (1) tumor size, (2) endophytic or exophytic tumor, (3) longitudinal location of the tumor, (4) the extent of the impairment renal parenchyma, (5) relationship with the renal sinus, (6) anterior or posterior. Results: The mean operative time, tumor size and bleeding increased proportionally to the increased complexity of the tumor measured by scores (p<0.0001, p<0.0001 and p=0.036, respectively). The mean total score was 8.7 points for patients undergoing partial nephrectomy (PN) and 14.4 points for those undergoing radical nephrectomy (RN) (p<0.0001). Larger tumors, completely endophytic, which exceeded the renal medulla and centrally located underwent radical nephrectomy (RN) more often (86.7% - p<0.0001, 64% - p=0.01, 77% - p<0.0001 and 78.9% - p<0.0001, respectively). In univariate analysis, RN was associated with tumors larger than 7 cm (p=0.001), tumors that exceeded the renal medullary (<0.001), centrally located tumors (OR=150 p <0.001) and tumors of high complexity (p<0.001). Analysis showed no association between complications and variables in the score. Conclusion: SARR is a simple, practical and intuitive classification for renal tumors that can be used in the decision-making process and to predict outcomes in the surgical treatment of renal tumors.
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    Lineage-Negative Bone Marrow Cells Protect Against Chronic Renal Failure
    (Alphamed Press, 2009-01-01) Alexandre, Cristianne Silva; Volpini, Rildo Aparecido; Shimizu, Maria Heloisa; Sanches, Talita Rojas; Semedo, Patricia [UNIFESP]; Di Jura, Vera Lucia; Camara, Niels Olsen [UNIFESP]; Seguro, Antonio Carlos; Andrade, Lucia; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Progressive renal failure continues to be a challenge. the use of bone marrow cells represents a means of meeting that challenge. We used lineage-negative (Lin(-)) cells to test the hypothesis that Lin(-) cell treatment decreases renal injury. Syngeneic Fischer 344 rats were divided into four groups: sham ( laparotomy only, untreated); Nx (five-sixth nephrectomy and untreated); NxLC1 (five-sixth nephrectomy and receiving 2 x 10(6) Lin(-) cells on postnephrectomy day 15); and NxLC3 (five-sixth nephrectomy and receiving 2 x 10(6) Lin(-) cells on postnephrectomy days 15, 30, and 45). On postoperative day 16, renal mRNA expression of interleukin (IL)-1 beta, tumor necrosis factor-alpha, and IL-6 was lower in NxLC rats than in Nx rats. On postnephrectomy day 60, NxLC rats presented less proteinuria, glomerulosclerosis, anemia, renal infiltration of immune cells, and protein expression of monocyte chemoattractant protein-1, as well as decreased interstitial area. Immunostaining for proliferating cell nuclear antigen showed that, in comparison with sham rats, Nx rats presented greater cell proliferation, whereas NxLC1 rats and NxLC3 rats presented less cell proliferation than did Nx rats. Protein expression of the cyclin-dependent kinase inhibitor p21 and of vascular endothelial growth factor increased after nephrectomy and decreased after Lin(-) cell treatment. On postnephrectomy day 120, renal function (inulin clearance) was significantly better in Lin(-) cell-treated rats than in untreated rats. Lin(-) cell treatment significantly improved survival. These data suggest that Lin(-) cell treatment protects against chronic renal failure. STEM CELLS 2009; 27: 682-692
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    Toll-like receptors-related genes in kidney transplant patients with chronic allograft nephropathy and acute rejection
    (Elsevier B.V., 2009-06-01) Nogueira, Eliana; Ponciano, Viviane Campos; Naka, Erika L.; Marques, Georgia D. M.; Cenedeze, Marcos A.; Saraiva Camara, Niels Olsen; Pacheco-Silva, Alvaro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Introduction: Toll-like receptors (TLR) comprehend an emerging family of receptors that recognize pathogen-associated molecular patterns and promote the activation of leukocytes. Surgical trauma and ischemia-reperfusion injury are likely to provide exposure to endogenous ligands for TLR in virtually all kidney transplant recipients.Methods: Macroarray (GEArray OHS-018.2 Series-Superarray) analyses of 128 genes involved in TLR signaling pathway were performed in nephrectomy samples of patients with chronic allograft nephropathy (CAN) and acute rejection (AR, vascular and non vascular). the analysis of each membrane was performed by GEArray Expression Analysis Suite 2.0.Results: Macroarray profile identified a gene expression signature that could discriminate CAN and AR. Three genes were significantly expressed between CAN and vascular AR: Pellino 2; IL 8 and UBE2V1. in relation to vascular and non-vascular AR, there were only two genes with statistical significance: IL-6 and IRAK-3.Conclusion: Vascular and non-vascular AR and CAN showed different expression of a few genes in TLR pathway. the analysis of nephrectomy showed that activation of TLR pathway is present in AR and CAN. (C) 2008 Elsevier B.V. All rights reserved.