IntroductionEntry into the retroperitoneal space during open posterior spinal surgery introduces the rare possibility of iatrogenic ureteral injury.Case presentationWe describe a case of ureteral injury after spinal surgery in a 49‐year‐old female with persistent lumbar pain and high fever 2 weeks after spinal surgery. After admission to the urology department, a computer tomography scan was performed and revealed right‐side hydronephrosis grade III and large retroperitoneal fluid collection. After radiological confirmation of right ureteral injury, a ureteral stent was placed, but 4 weeks later, ureteral stricture was confirmed on antegrade pyelography. Therefore, surgical ureteroplasty was indicated 2 months after initial admission to the urology department. Six weeks later, the stent was removed, and intravenous pyelography revealed a normal ureteral passage.ConclusionThere should be a low threshold for ureteral injuries after spinal cord surgery in patients with high fever and elevated blood creatinine levels.
Objective: To estimate the efficacy of our technique of zero ischemia time partial nephrectomy (ZTPN) with hemostatic running suture and compare it to the standard technique, in terms of perioperative complications, operative time (OT) and estimated blood loss (EBL). Materials and methods: We retrospectively analysed 180 consecutive patients who underwent ZTPN using a supra 11 th or supra 12 th rib mini flank approach. First group numbered 90 patients treated with running suture hemostatic technique (RSHT), while the control group enrolled 90 patients in whom we performed standard reconstruction technique (SRT).According the propensity score, both groups were similar in terms of tumor size, age and PADUA score. Patients with solitary tumour limited to the kidney (T1-T2a) were included. Our technique included a running suture of surgical bed edges and closure of the renal cortex by the positioning of peri-renal fat within the cortical bed and fixation with interrupted sutures. Results: PADUA score and tumor size were comparable between groups (7.12 ± 1.33 vs 7.1 ± 2.11, p = 0.4 and 52.9 ± 14.8 vs 50.0 ± 13.2, p = 0.3) first group (165.2 vs 95, p = 0.04 . The mean operative time (OT) was significantly longer in ), while median estimated blood loss (EBL) was significantly reduced (250 vs 460 ml, p = 0.02). Surgical resection margins were negative in 100% of cases and no patient developed a local or distant recurrence during follow up. There was significant difference in postoperative GFR value between groups (p < 0.05). Conclusions: Our technique could be safely performed in local, low volume facilities, thus reducing the need for expensive and more challenging minimal invasive surgical techniques.. SummaryNo conflict of interest declared.Archivio Italiano di Urologia e Andrologia 2019; 91, 2Open partial nephrectomy with specific hemostatic technique CorrespondencePetar Kavaric, MD, PhD
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