Urologic Surgery with Multisystem Comorbidities: A Case Report

Abstract

Patient: Female, 70Final Diagnosis: Renal cell carcinomaSymptoms: Epistaxis • exertional dyspneaMedication: —Clinical Procedure: Radical nephrectomySpecialty: UrologyObjective:Rare diseaseBackground:Originally implemented for colorectal surgery, enhanced perioperative protocols have been incorporated into many surgical fields in an effort to improve outcomes. The cornerstone of many strategies includes patient education, liberalized oral intake on the day of surgery, no routine bowel prep, targeted multimodal analgesia, cautious use of IV hydration, early extubation, avoidance of NG tubes and/or surgical drains, and encouraging early postoperative ambulation.Case Report:We report on the successful outcome of a single patient with a rare autosomal dominant disorder (hereditary hemorrhagic telangiectasia) with multisystem involvement including pulmonary, cardiac, hematologic, gastrointestinal, renal, oncologic, and hepatic comorbidities, scheduled for open nephrectomy.Conclusions:Prospective and retrospective studies are needed to specifically elucidate the role of similar management in higher-risk surgical candidates.

Characteristics and Treatment Outcomes of Urologic Patients Admitted to the Intensive Care Unit, Osijek University Hospital Center

“…In this study, the most common reasons for admission to the ICU from the Department of Urology were respiratory failure, hemodynamic instability, and CPR. Other studies also showed that hemodynamic instability, the frequency of vasopressor use, and admission to the ICU were more common after cardiorespiratory arrest in patients with comorbidities and a history of tumors ( 9 , 21 , 22 ).…”