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Original articleAbdominal pelvic radiotherapy prolongs surgical time of retrograde endoscopic treatment of upper urinary tract stones

Objective: the main objective is to assess whether urolithiasis diagnosed in patients with previous APRT need more endoscopic procedures to reach stone-free status and if these procedures are longer. The secondary objective is to find out if these patients have more complications resulting from endourologic procedures. Design and methodology: we designed a case-control unicentric study including patients with upper urinary tract lithiasis treated with retrograde ureterorenoscopy (URS) between 2006 and 2022. Case patients have previous history of APRT, while controls are patients without this history. We collected epidemiological, lithiasis and treatment related information in both groups. Results: we identified 18 upper urinary tract stones in cases that underwent endoscopic retrograde treatment. We linked these urinary stones with 18 urolithiasis diagnosed in control patients. The average age in patients and the diameter of the stones diagnosed were very similar in both groups, as well as the stones’ location. Longer surgical time was found for lithiasis treatment in case patients (129.6 versus 80.2 minutes in controls, p = 0.025). No significant differences were found regarding the rest of variables. Limitations: this is a retrospective and observational study, and the sample size is small, so we need to expand to a multicentric study. Originality and value: to our best knowledge this is the first study to provide data on how APRT may affect the effectiveness of endourological treatment of urolithiasis. Conclusion: endourological procedures for treatment of upper urinary tract stones in patients with previous APRT are longer than in patients without this background.

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Resección pancreática por cáncer de células renales metastásico: experiencia de un hospital mexicano de alto volumen

Objective: The aim of our study was to report the oncological and surgical outcomes of the pancreatic resections due to solitary pancreatic metastasis of RCC in a tertiary care reference center for pancreatic masses in Mexico. Materials y methods: All pancreatic resections at our Institution from 2002 to 2022 were retrospectively analyzed. We only included patients treated with pancreatic resections due to metastatic RCC to the pancreas. We evaluated symptoms, time from nephrectomy to pancreatic resection, type of surgery, complications and oncological outcomes. Results: Eight pancreatic resections due to solitary metastases of RCC were performed. The median age of presentation was 69 years. The most prevalent symptom was abdominal pain (50 %). 6 pancreatoduodenectomies (Whipple procedure), 1 distal pancreatectomy and 1 total pancreatomy were done. The median time between radical nephrectomy and pancreatic resection was 122 months (8-247 months). Seven had negative surgical margins. The median follow-up time after pancreatic surgery was 42 months (1-109 months). The only case that died had pulmonary metastases and the resection was R1. Originality and value: Original study demonstrating the survival outcomes of pancreatic resection for metastatic renal cell carcinoma in a high-volume hospital in Mexico. Limitations: Retrospective study and the limited number of cases. Conclusions: Pancreatic resections due to solitary metastases from CCR could offer some advantages on survival, as long as they are done in high volume centers.

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