Examinando por Autor "Rubio L., Gonzalo"
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Ítem Drenaje Percutáneo de Absceso Renal en Niños: Caso Clínico(Sociedad Chilena de Pediatría, 2010) Castillo C., Octavio A.; Rubio L., Gonzalo; Vidal M., Ivara; Portalier F., PauloRenal abscesses in children are rare. Percutaneous draining is a useful tool, frequently used among adults. The objective of this presentation is to present a pediatric case of a percutaneous-drained renal abscess. Patients and Methods: A 9 year old girl with a history of recurring acute left pyelonephritis was admitted for a new episode, which evolved into a 4.6 cm renal abscess, detected on a sonogram. Antibiotic treatment was effective, resulting in clinical and image resolution. Ten days post treatment, the abscess recurred, this time it was treated with an aspiration punction and antibiotics, with a good clinical response. Follow up image showed resolution. Again, followup showed a recurrence of the abscess. This time a percutaneous drain was utilized, with complete clinical and image resolution. Various therapeutic alternatives, and the use of drains in children are discussed.Ítem Linfadenectomía lumboaórtica asistida por robot en tumor residual postquimioterapia en cáncer testicular(Sociedad de Cirujanos de Chile, 2011) Castillo C., Octavio A.; Sepúlveda T., Francisco; Susanibar N., Luis F.; Vidal M., Ivar; Rubio L., GonzaloIntroduction: The laparoscopic retroperitoneal lymph node dissection (L-RPLND) has shown results at least comparable to open surgery in terms of perioperative complications and oncological results, but its application in the post chemotherapy scenario is still matter of study. The development of robotic surgery and its advantages over laparoscopic surgery, make this an attractive option for complex procedures. We report our initial experience with robotic-assisted retroperitoneal lymph node dissection (R-RPLND). Methods: We describe the cases of two patients who underwent R-RPLND due to a Post Chemotherapy residual mass of a non-seminomatous testicular cancer. Results: Two patients, 27 and 30 years old, presented with retroperitoneal residual mass after 4 and 6 cycles of Bleomicin, Etoposide and Cis-Platinum. The first patient had a 4.3 cm left para-aortic mass and the other had a 6 cm mass behind the third portion of the duodenum. The mean surgical time was 255 minutes (210-300), with an estimated mean blood loss of 450 cc (100-800) and a mean hospital stay of 60 hours (72-48). The pathologic result was Teratoma in both cases. There was no periopera-tive morbidity. Conclusions: We believe that R-RPLND is a feasible and safe alternative in selected patients. However still needs more experience and longer follow up to asess its oncological outcome.Ítem Ureterectomía radical distal por cáncer urotelial y reconstrucción ureteral asistida por robot(Sociedad de Cirujanos de Chile, 2011) Castillo C., Octavio A.; López-Fontana, Gastón; Vidal M., Ivar; Rubio L., Gonzalo; Gómez I., ReynaldoObjective: To report a case of distal ureterectomy with robotic-assisted laparoscopic reimplantation using a Boari flap technique. Material and Methods: We report a 55 year old man with a diagnosis of distal ureteral urothelial carcinoma without multifocality. Results: A radical distal ureterectomy and robotic-assisted laparoscopic vesicoureteral reimplantation using a Boari flap technique was performed with the da Vinci S-HD surgical system. The operative time was 210 minutes, the estimated blood loss was 200 mL. The hospital stay was 48 hours, without perioperative complications. The histopathological study showed a high grade non-muscle invasive urothelial carcinoma of the distal ureter (pT1NxMx) with negative margins. Conclusions: The distal radical ureterectomy with Boari replacement is feasible and more precise with robotic assistance. Its oncological role must be demostrated with a larger number of cases.