calcifications and the enhancement pattern on computed tomography (CT) imaging, correlates with clinicopathologic features and outcomes of patients with gastroenteropancreatic neuroendocrine tumors. We sought to investigate whether these radiographic characteristics were prognostic among patients with neuroendocrine liver metastases (NELM) undergoing surgical resection. Methods: The preoperative contrast-enhanced CT scans of all patients who underwent resection of NELM at a single institution between 2000e2015 were retrospectively reviewed. The presence of calcifications was determined on non-contrast phase imaging. Enhancement on the arterial phase scan was categorized as hyperenhancing, hypoenhancing, or mixed. Relevant clinicopathologic characteristics as well as recurrence-free (RFS) and overall-survival (OS) were compared between groups. Results: Among 82 patients who underwent resection of NELM, 56 had available data on calcifications while 50 had data available on arterial enhancement patterns. Among all patients, median age was 58 (IQR 47-63) and the majority were female (N = 48, 58%). The most common primary tumor locations were pancreas (N = 25, 30%) and small bowel (N = 27, 33%). The most commonly performed procedures were right hepatectomy (N = 21, 28%) and bisegmentectomy (N = 14, 19%). Median tumor number was 3 (IQR 1e5), median Ki-67 was 5% (IQR 2%e10%), and median size of the largest liver metastases was 4.5 cm (IQR 2.8e7.7). Twelve (21%) patients had tumor calcifications. Among patients with and without calcifications there were no differences in demographics, clinicopathologic characteristics, RFS (p = 0.917) or OS (p=0.104). Arterial enhancement was hypoenhancing in 23 (47%), hyperenhancing in 9 (19%), and mixed in 16 (34%). Similarly, there were no differences between arterial enhancement groups in demographics, clinicopathologic characteristics, RFS (p = 0.303) or OS (p = 0.258). Conclusion: Radiographic characteristics on contrastenhanced CT are not associated with the outcomes of patients undergoing resection of NELM. Future investigations should evaluate the prognostic impact of functional neuroendocrine imaging.Background: Although MELD score is a reliable tool for estimating mortality in the waiting list, criteria for preoperative prediction of survival after liver transplantation (LT) are lacking. ALBI score was validated as a prognostic marker for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization, hepatic resection and sorafenib treatment but not for LT outcomes yet. This study aimed to evaluate ALBI score as a prognostic factor in LT. Methods: Single center analysis of patients undergoing LT between October 2001 and June 2017. Primary endpoint was overall post-LT mortality. Secondary endpoint was 90th day mortality. Results: Of all 301 patients included in this study, 185 (61.5%) were males. The mean age was 54.1 AE 11.3 years. Univariate and multivariate analyses revealed that ALBI grade 3 (HR = 1.836, 95%CI [IQR=1.154e2.921], p = 0.010), low serum al...
CONTEXT: Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure. OBJECTIVE: Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program. CASE REPORT: A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm. The length of the surgery was 3 hours and 15 minutes. The kidneys were removed after the aspiration of some cysts through the supra-umbilical incision. Pain control was achieved via the use of analgesics. The blood loss during surgery was 160 ml. During the postoperative period, the patient developed right-side pneumothorax, which was drained with no further occurrence. This drain was kept in place for 48 hours. The length of hospitalization was 4 days.
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