Purpose: To compare perioperative outcomes, complications and anastomotic stricture rate in a contemporary series of patients who underwent open radical cystectomy (RC) with modifi ed Wallace anastomotic technique versus traditional ileal conduit. Materials and methods: Study enrolled 180 patients, of whom 140 were randomized and underwent RC; seventy were randomized to group I and the seventy to the group II. For the primary objective, we hypothesized that the rate of ureteroenteric strictures would be at least 20 % lower in the second group. Secondary end points included rate of anastomotic leak, surgical time, deterioration of the upper tract, intraoperative blood loss and patient-reported quality of life (HRQOL). The modifi ed Wallace 1 technique involved eversion of the ureteral plate and bowel mucosa edges, which were anastomosed together in running fashion, while the outher anastomotic wall was augmented with sero-serosal interrupted sutures. Results: The mean (SD) follow-up time was 26.1 (5.7) months in group I and 25.2 (4.8) months in group II, during which, anastomotic stricture was observed in 8 patients (12%) from the fi rst and 2 patients (3%) from the second group (p < 0.05). The anastomotic leakage rate was signifi cantly higher in fi rst group (17% vs. 8.5%, p< 0.05), while patient-reported HRQOL outcomes were similar between groups after the 12 month follow-up period. Conclusions: By using a modifi ed Wallace technique, we were able to signifi cantly lower anastomotic stricture and anastomotic leakage rates, which are major issues in minimizing both short-and long-term postoperative complications.
AbstractRenal lipoma is a very rare tumor that has only been described in about twenty cases in adults and in a single case in a child aged 2 years. This paper presents a renal lipoma in 63 year old female patient. The tumor size of 7.5×4.5 cm was located in her right kidney, clearly delineated from the surrounding kidney tissue, and histology was completely built of mature adipose tissue. This paper describes the case of a rare benign lipoma which histogenesis is yet not clearly understood.
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