Objective: To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). Method: We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). Results: The mean stone size was 12.23 +/-5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.
In the last decade, immediate reconstruction of maxillary bones following extensive trauma, large oncological defects, or late effects of radiation therapy has proved to be a reliable morpho-functional reconstruction technique. Use of the vascularized iliac crest with an internal oblique flap has become our flap of choice for mandible reconstruction when there is no need for overlying facial skin or oral sphincter reconstruction, and for bone segments within 6-15 cm of length. The advantages of this composite bone flap are the large and resizable bone stock available, the quality of bone transferred with an optimal height, depth, and contour of bone to maintain a good facial profile, and the possibility to reconstruct properly the oral lining, with a portion of the internal oblique muscle flap raised with the same pedicle that epithelializes during the healing stages. We present the experience of the Department of Maxillofacial Surgery of "S. Maria della Misericordia" Regional Hospital in Udine, Italy.
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