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Ayoub E, Kutchukian S, Bigot P, Dinh A, Gondran-Tellier B, Robin H, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ducousso H, Bernardeau S, Bruyère F, Vallée M. Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database. World J Urol 2024; 42:179. [PMID: 38507063 DOI: 10.1007/s00345-024-04853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/06/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence. Our main end point in this study is to analyze the relationship between preoperative urine culture and the risk of postoperative febrile urinary tract infection (UTI) or surgical-site infection (SSI) in partial or radical nephrectomy patients. METHODS We conducted a multicenter retrospective cohort study between January 2016 and January 2023 in 11 French tertiary referral hospitals (TOCUS database). We collected the data for 269 patients including several pre-, intra-, and post-operative variables that could potentially increase the risk of postoperative UTI and SSI including preoperative urinary culture results. RESULTS The incidence rate of postoperative UTI and SSI was 8.9% in our study. After conducting a logistic multivariate analysis, a propensity score matching analysis, and a subgroup analysis, we found no significant correlation between the urine culture and the postoperative UTI risk [OR = 1.2 (0.5-2.7) (p = 0.7)]. Only the postoperative non-infectious complications were related to a higher risk of postoperative UTI [OR = 12 (4-37), p < 0.001)]. CONCLUSION Our research shows that screening and treating for ABU prior to radical or partial nephrectomy seems to be unnecessary to prevent postoperative UTI and SSI.
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Affiliation(s)
- Elias Ayoub
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France.
| | - Stessy Kutchukian
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Pierre Bigot
- Département d'urologie Centre Hospitalier Universitaire, Angers, France
| | - Aurélien Dinh
- Service de maladies infectieuses, Centre Hospitalier Universitaire, R. Poincaré, APHP, GarchesUniversité Versailles Paris Saclay, IHU PROMETHEUS, Paris, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
| | - Bastien Gondran-Tellier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Humphrey Robin
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Marc Françot
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | | | - Jérôme Rigaud
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | - Mathilde Chapuis
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Laurent Brureau
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Camille Jousseaume
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Omar Karray
- Département d'urologie Centre Hospitalier, Pontoise, France
| | - Fares T Kosseifi
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | - Shahed Borojeni
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | | | - Harrison-Junior Asare
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Maxime Gaullier
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Baptiste Poussot
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Thibault Tricard
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Michael Baboudjian
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Éric Lechevallier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pierre-Olivier Delpech
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Héloïse Ducousso
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Simon Bernardeau
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Franck Bruyère
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Département d'urologie Centre Hospitalier Universitaire, Tours, France
| | - Maxime Vallée
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Université de Poitiers, unité INSERM U1070, PHAR2, 86000, Poitiers, France
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Yarak N, Zouari S, Karray O, Sleiman W, Abdelwahab A, Bart S, Abdessater M. The "Cut-to-the-Light" Technique Laser Endoureterotomy for Complete Ureteral Obstruction Resurfaces! A New Application of an Old Technique. Res Rep Urol 2022; 14:351-358. [PMID: 36246791 PMCID: PMC9562977 DOI: 10.2147/rru.s371856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/13/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To describe our new endoscopic approach in treating iatrogenic ureteral stenosis using the “cut-to-The-light” technique. Methods Case of a 54 year-old female patient who underwent a right percutaneous nephrolithotomy to treat a staghorn calculus with two subsequent complimentary ureteroscopies complicated by a severe proximal ureteral obstruction. An antegrade flexible uretereroscope and a retrograde rigid ureteroscope were used to locate the stenosis. With the aid of a 365-µm Ho: YAG laser fiber (settings 0.4 J, 12 Hz), we managed to successfully create a small incision in the stenotic lesion, the rigid ureterscopy light was clearly seen by the antegrade flexible ureteroscope and a through-and-through guidewire was then placed, securing the ureter. Ureteral dilatation was then performed followed by a full thickness incision of the ureteral stenosis. A single 8Fr, 28 cm double J ureteral stent was finally placed after stone fragmentation. Results The operating time was 200 mins. No blood loss. No fever or signs of UTI were seen shortly after the operation. The Foley catheter was successfully removed at day one post-op. The hospital stay was short of only 2 days. Conclusion The “cut-to-the-light” technique is a new application in the arsenal of ureteral stricture treatment that has been scarcely described in the literature before. The use of this method seems to offer excellent outcomes thus demonstrating the importance of this minimally invasive technique as an alternative to conventional invasive methods used. We believe that studies with larger samples and longer follow up are needed in order to fully determine the benefits of this method and to assess and reveal its suitable application and its drawbacks.
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Affiliation(s)
- Naim Yarak
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Skander Zouari
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Omar Karray
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Walid Sleiman
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Alaa Abdelwahab
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Stéphane Bart
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France
| | - Maher Abdessater
- Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France,Correspondence: Maher Abdessater, Email
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Stessy K, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Bruyère F, Gondran-Tellier B, Vallée M. Epidemiology of asymptomatic bacteriuria prior urological surgery: preliminary results of the retrospective and multicenter TOCUS study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brureau L, Chapuis M, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Gondran-Tellier B, Bruyère F, Kutchukian S, Vallée M. Risk factors of infectious complications after benign prostatic hyperplasia surgery: Preliminary results from the retrospective and multicenter TOCUS cohort. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Stessy K, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Bruyère F, Gondran-Tellier B, Vallée M. Risk factors for postoperative infections after urological surgery: Preliminary results from the national and multicenter TOCUS study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00202-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Karray O, Tolner S, Yarak N, Cherfan M, Cosma MD, Sleiman W, Niclot P, Dubost JL, Coloby P, Bart S. Rare paraneoplastic syndrome of prostatic cancer: limbic encephalitis: a case report. J Med Case Rep 2021; 15:405. [PMID: 34315545 PMCID: PMC8317402 DOI: 10.1186/s13256-021-02975-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 06/21/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction Limbic encephalitis is an autoimmune neurologic disorder, often of paraneoplastic origin, that seldom complicates prostatic tumors. The nonspecificity of symptoms makes the diagnosis sometimes difficult to establish. Prognosis is essentially determined by comorbidities and sensorineural and cognitive sequelae.
Clinical case A 66-year-old Caucasian patient known to have prostatic small-cell neuroendocrine adenocarcinoma under hormonal therapy developed complex partial epileptic seizures associated with rapidly aggravating severe memory impairment. The tripod of autoimmune limbic encephalitis diagnosis was based on the clinical aspect of brain’s functional deterioration, electroencephalography aspect, and γ-aminobutyric acid type B anti-receptor antibody positivity. Clinical, diagnostic, and therapeutic management as well as evolutionary risks were further analyzed. Conclusion Limbic encephalitis is an extremely rare presentation of neurologic paraneoplastic syndromes. A better knowledge of this entity would help better manage diagnostic and therapeutic difficulties and reduce the risk of possible sequelae.
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Affiliation(s)
- Omar Karray
- Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France.
| | - Sven Tolner
- Neurology Department, René Dubos Hospital, Pontoise, France
| | - Naïm Yarak
- Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France
| | - Maguy Cherfan
- Pathology Department, René Dubos Hospital, Pontoise, France
| | | | - Walid Sleiman
- Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France
| | | | | | - Patrick Coloby
- Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France
| | - Stéphane Bart
- Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France
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Sleiman W, Karray O, Abi Abdallah M, Bleichner-Perez S, Kourda J, Cosma-Opris M, Assouad S, Riffaud JC, Bart S, Coloby P. Large-cell neuroendocrine tumor of the prostate: a case report and review of the literature. J Med Case Rep 2021; 15:254. [PMID: 33957979 PMCID: PMC8103761 DOI: 10.1186/s13256-021-02830-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 03/26/2021] [Indexed: 12/19/2022] Open
Abstract
Background Primitive neuroendocrine prostate neoplasms are rarely reported. This entity comprises carcinoïd tumors and poorly differentiated neuroendocrine tumors, mainly those of the small-cell type. Large-cell-type primitive tumors are exceptional, and only nine cases are reported in the literature. Similar to neuroendocrine tumors of the prostate, large-cell-type primitive tumors may be observed in the context of conventional adenocarcinoma during androgen deprivation therapy or as prostatic metastasis of a distant neuroendocrine tumor, mainly pulmonary neoplasms. Case presentation We report a Caucasian case of a mixed prostatic carcinoma, with the largest component being the large-cell neuroendocine carcinoma, in a patient who underwent a total prostatectomy for a localized cancer. Diagnostic, histological, therapeutic and evolutive aspects are reported and discussed. Conclusions Large-cell primitive prostate neuroendocrine carcinoma is a rare but aggressive histological entity, which can be associated or not with an adenocarcinomatous component. Mixed forms have a better outcome, mainly when diagnosed at an early stage.
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Affiliation(s)
- Walid Sleiman
- Urology Department, René Dubos Hospital, Pontoise, France
| | - Omar Karray
- Urology Department, René Dubos Hospital, Pontoise, France.
| | | | | | - Jihen Kourda
- Pathology Department, René Dubos Hospital, Pontoise, France
| | | | - Sabine Assouad
- Oncology Department, René Dubos Hospital, Pontoise, France
| | | | - Stéphane Bart
- Urology Department, René Dubos Hospital, Pontoise, France
| | - Patrick Coloby
- Urology Department, René Dubos Hospital, Pontoise, France
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Boubaker NS, Gurtner A, Trabelsi N, Manni I, Said R, Ayed H, Ksentini M, Karray O, Saadi A, Essid MA, Blel A, Rammeh S, Chebil M, Piaggio G, Ouerhani S. Evaluating prognostic utility of preoperative Neutrophil to Lymphocyte Ratio and hsa-let-7g/c up-regulation in patients with urinary bladder cancer. Cancer Biomark 2020; 27:63-73. [PMID: 31683460 DOI: 10.3233/cbm-190483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Stratification and risk-evaluation of bladder cancer (BCa) patients are far-reached issues, especially for those with non muscle invasive disease. Thus, setting-up biomarkers, especially after resection of the primary tumor, is crucial. Specifically, Neutrophil to lymphocyte ratio NLR and let-7 deregulation which have been preliminarily but not consistently described to be associated to unfavorable prognosis. OBJECTIVE To explore the clinical value of pre-treatment Neutrophil to Lymphocyte Ratio (NLR), let-7c and let-7g's deregulation. METHODS Data were extracted from ninety BCa samples. Pre-treatment NLR was estimated as the absolute neutrophil count divided by the absolute lymphocyte count. Expression patterns of let-7c and let-7g were assessed by qRT-PCR. Correlation with clinical characteristics was performed by descriptive statistics. RESULTS Both let-7 miRs were upregulated. Interestingly, let-7g was associated to pathological stage (p= 0.001) and tumor multiplicity (p= 0.003). NLR was associated to histological grade (p= 0.005) and clinical stage (p= 0.006). They were both associated to more aggressive phenotype and their worth as potential stratification biomarkers was confirmed by ROC curve. CONCLUSIONS Our data demonstrated the potential clinical value of all markers, especially pretreatment NLR and let-7g. Further studies are recommended to confirm their utility in improving the clinical decision-making regarding treatment and follow-up scheduling.
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Affiliation(s)
- Nouha Setti Boubaker
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia.,UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Aymone Gurtner
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Nesrine Trabelsi
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia
| | - Isabella Manni
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Rahma Said
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia
| | - Haroun Ayed
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia.,Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Meriem Ksentini
- Pathology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Omar Karray
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ahmed Saadi
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia.,Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Ahlem Blel
- Pathology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Pathology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Giulia Piaggio
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules, INSAT, University of Tunis Carthage, Tunis, Tunisia
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Karray O, Akassimadou N, Bart S, Cosma-Opris M, Coloby P, Sleiman W. Testicular plasmocytoma as an unsual late relapse of multiple myeloma. Urol Case Rep 2020; 31:101181. [PMID: 32309145 PMCID: PMC7154997 DOI: 10.1016/j.eucr.2020.101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/27/2020] [Indexed: 11/15/2022] Open
Abstract
Among extramedullary manifestations of multiple myeloma, testicular localization is exceptional. A scrotal mass in this context poses diagnostic and therapeutic challenges given the aesthetic, psychological and reproductive impact of surgery. Authors report a case of testicular plasmocytoma seven years after remission from multiple myeloma. The treatment consisted of left inguinal orchidectomy. Diagnosis needed the recourse to immunohistochemistry. Diagnostic modalities, therapeutic options and evolutive eventualities will be discussed. Extra-medullar localization is exceptionally reported in extramedullary multiple melanoma. Management depends on the concomitant or distant character of hemopathy diagnosis and the disease evolutive history.
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Affiliation(s)
- Omar Karray
- Urology Department, René Dubos Hospital, Pontoise, France
| | | | - Stéphane Bart
- Urology Department, René Dubos Hospital, Pontoise, France
| | | | - Patrick Coloby
- Urology Department, René Dubos Hospital, Pontoise, France
| | - Walid Sleiman
- Urology Department, René Dubos Hospital, Pontoise, France
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Karray O, Ayed H, Saadi A, Zaghbib S, Henchir S, Cherif A, Ben Miled A, Chakroun M, Bouzouita A, Derouiche A, Ben Slama R, Chebil M. Is imagery distinctive in papillary renal cell carcinoma subtypes? Tunis Med 2020; 98:131-137. [PMID: 32395802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The subdivision into two entities of papillary renal cell carcinoma (PRCC) was established on histological criteria. It's in fact possible to distinguish the two subtypes by the means of radiological and progressive data. The subtype 1 is associated with the favorable profile. The ultrasound and especially CT urography ensure an accurate diagnostic approach with substantial therapeutic and prognostic involvement. The aim of the study is to define the radiological features that distinguish the two subtypes of renal papillary carcinoma, and to study the radiological predictive factors of locoregional recurrence, metastases free survival and specific survival. METHODS It's about a monocentric, retrospective study led between January 2005 and June 2017, gathering 49 cases of operated PRCC. The study concerned patients over the age of 18, who were diagnosed after anatomopathological examination of the operative specimen (enlarged nephrectomy or conservative surgery). Cases in which diagnosis was made by renal biopsy were excluded. The comparative study concerned ultrasound and CT scan data. Univariate and multivariate analysis were performed to determine factors having a prognostic value in terms of locoregional recurrence, metastases-free and specific survival. RESULTS On the ultrasound, the subtype 1 tumors were significantly homogenous with regular contours. Tumors were globally spontaneously hypodense and hypo vascular in 97,8% of cases. Enhancement was significantly more heterogonous for subtype 2 (p=0,01). Intratumoral necrosis and adenomegalies were associated with subtype 2 (p=0,0001 and 0,005). The predictive factors of locoregional recurrence, metastases-free survival and specific survival in univariate analysis were the contours' aspect, moderate enhancement and the presence of adenomegalies. On multivariate analysis, only the irregular contours were retained for locoregional recurrence-free survival and specific survival. CONCLUSIONS Significant differences between the PRCC subtypes were observed when studying the radiological data. Irregular contours, adenomegalies and enhancement degree seemed to predict the progression of PRCC after curative surgery.
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Boubaker NS, Spagnuolo M, Trabelsi N, Said R, Gurtner A, Regazzo G, Ayed H, Blel A, Karray O, Saadi A, Rammeh S, Chebil M, Rizzo MG, Piaggio G, Ouerhani S. miR-143 expression profiles in urinary bladder cancer: correlation with clinical and epidemiological parameters. Mol Biol Rep 2019; 47:1283-1292. [PMID: 31863330 DOI: 10.1007/s11033-019-05228-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/07/2019] [Indexed: 02/07/2023]
Abstract
Hsa-mir-143 and hsa-let-7c have been reported to be deregulated in multiple neoplasms. The main purpose of this study was to investigate the expression of these miRNAs in bladder cancer (BCa) and to analyze the association between their expression profiles and clinical and epidemiological parameters. Ninety BCa specimens were included. Expression patterns of miR-143 and let-7c were assessed by qRT-PCR using Taqman specific probes. Validated and predicted targets of these miRNA's were identified using CSmiRTar and DAVID tools, respectively. miR-143 was downregulated in tumors compared to controls (mean fold-change (FC) = 0.076). Its expression was significantly higher in MIBC compared to NMIBC (p = 0,001). Its value as a potential biomarker discriminating non invasive tumors from the invasive ones was confirmed by ROC curve (AUC = 0.768; p = 0.0001). Also, this down-regulation positively correlates with frequency of tobacco use (p = 0,04) and chronic alcohol consumption (p = 0,04). Let-7c was overexpressed in BCa samples (mean (FC = 9.92) compared to non tumoral ones but was not associated to clinical and epidemiological parameters. A comprehensive overview of miR-143 targets and pathways implicated in BCa initiation, diagnosis or prognosis using bioinformatical analysis, was conducted. While both deregulated miRNAs may contribute to urothelial tumorigenesis, the deregulation of miR-143 was significantly correlated to epidemiological and clinical parameters.
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Affiliation(s)
- Nouha Setti Boubaker
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia.,Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, UOSD SAFU, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Manuela Spagnuolo
- Oncogenomic and Epigenetic Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Nesrine Trabelsi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia
| | - Rahma Said
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia
| | - Aymone Gurtner
- Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, UOSD SAFU, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Giulia Regazzo
- Oncogenomic and Epigenetic Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Haroun Ayed
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia.,Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ahlem Blel
- Pathology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Omar Karray
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ahmed Saadi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia.,Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Pathology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Maria Giulia Rizzo
- Oncogenomic and Epigenetic Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Piaggio
- Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, UOSD SAFU, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), National Institute of Applied Sciences and Technology of Tunis (INSAT), The University of Tunis Carthage, Via Elio Chianesi 53, 00144, Tunis, Tunisia.
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Saadi A, Saadi H, Chakroun M, Karray O, Achour N, Bouzouita A, Derouiche A, Ben Slama R, Mnif N, Ayed H, Chebil M. Traumatismes scrotaux : intérêt de l’échographie préopératoire dans la prédiction de la rupture de l’albuginée. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Karray O, Khouni H, Charfi M, Boulma R, Debaibi M, Makhlouf R, Bargaoui K, Nessej O, Seridi A, Fourti S, Bouhaouala MH, Chouchene A. Ureteral tumor in an ectopic duplex system: a case report. J Med Case Rep 2019; 13:70. [PMID: 30845986 PMCID: PMC6407215 DOI: 10.1186/s13256-019-1974-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 01/07/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ureteral ectopia is a rarely observed anomaly. It may be totally asymptomatic. An association with a duplex system is exceptional. Diagnostic and therapeutic approaches are challenging. Carcinologic surgery must consider the anatomic variant, mainly related to the ectopic site of the ureteral orifice. OBSERVATION We report a case of a ureteral urothelial carcinoma in a North African 52-year-old male patient, in a right duplex system. Radiological explorations concluded a non-functional upper right kidney. A suspect mass was observed in the lumbar part of the ureter of the right upper system. The meatus of the tumorous ureter ended in the right lobe of the prostate. A right hemi-nephro-ureterectomy was performed. A histological examination concluded a pT2G2 urothelial carcinoma. CONCLUSION Even if malignancy is rarely observed in ureteral ectopia, it should be evoked mainly in cases of hematuria with risk factors for urothelial tumors.
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Affiliation(s)
- Omar Karray
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia.
| | - Hassen Khouni
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Mahdi Charfi
- Medical Imagery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Rami Boulma
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Mehdi Debaibi
- General Surgery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Rym Makhlouf
- Medical Imagery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Karim Bargaoui
- Medical Imagery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Oumeima Nessej
- Medical Imagery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Azza Seridi
- General Surgery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - Slim Fourti
- Medical Imagery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | | | - Adnene Chouchene
- General Surgery Department, Interior Security Forces Hospital, La Marsa, Tunisia
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14
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Karray O, Batti R, Talbi E, Ayed H, Chakroun M, Ouarda MA, Bouzouita A, Cherif M, Ben Slama MR, Amel M, Abdelmoula J, Derouiche A, Chebil M. Purple urine bag syndrome, a disturbing urine discoloration. Urol Case Rep 2018; 20:57-59. [PMID: 29992092 PMCID: PMC6034577 DOI: 10.1016/j.eucr.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Omar Karray
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Rym Batti
- Oncology Department, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Emna Talbi
- Biochemistry Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Haroun Ayed
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Marouene Chakroun
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Mouna Ayadi Ouarda
- Oncology Department, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Abderrazek Bouzouita
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Mohamed Cherif
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Mohamed Riadh Ben Slama
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Mezlini Amel
- Oncology Department, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Jouida Abdelmoula
- Biochemistry Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Amine Derouiche
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
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15
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Karray O, Saadi A, Chakroun M, Ayed H, Cherif M, Bouzouita A, Slama MRB, Derouiche A, Chebil M. Retro-peritoneal paraganglioma, diagnosis and management. Prog Urol 2018; 28:488-494. [PMID: 29983333 DOI: 10.1016/j.purol.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/06/2018] [Accepted: 06/07/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Paragangliomas, defined as extra-adrenal chromaffin-cells tumors, are rarely located in the retro-peritoneum. Clinical presentation is similar to pheochromocytoma, and mainly depends on the producing character of the tumor. Positive diagnosis requires plasmatic and urinary hormonal assays. Radiological and isotopic explorations are essential before surgery. The only curative therapeutic strategy is surgical, associated to peri-operative prevention and monitoring of the frequently reported hemodynamic and cardiovascular disorders. Outcome depends of the metastatic character of the tumor, the presence of tumor remnant after surgical resection. Genetic study is recommended; the risk of recurrence and association to other neoplasm is more described in genetic forms. MATERIAL AND METHODS Authors report 5cases of retro-peritoneal paraganglioma, operated in the department of urology of Hospital, between 2013 and 2017. Observations are about 2men and 3women. Clinical presentation is not always specific and paraganglioma may be discovered fortuitously. Two patients have been operated by coelioscopic approach, midline incision was performed in two other cases, and dorsal lumbotomy associated to a Rutherford-Morrison incision in a patient. RESULTS Two patients presented resistant hypertension and palpitation associated to suspect retro-peritoneal masses in imagery and elevated urinary methoxylated derivates before surgery. One patient was asymptomatic and the tumor was discovered in imagery. Per-operative hypertensive crisis and sinus tachycardia occurred in a case. The average follow-up period is 22.8months. Hypertension and palpitation disappeared after surgery. There was no recurrence for all the operated patients. CONCLUSION Retro-peritoneal paraganglioma is a rare condition. Symptoms are not specific and clinical presentation may be similar to pheochromocytoma. Abdominal CT-scan and MRI, in association with MIBG scintigraphy are strongly evocative. Histological examination ensures diagnosis. Per-operative cardio-vascular disorders are to consider and must prevented and managed by anesthesiologists. Complete surgical resection is the only curative treatment and avoids recurrences.
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Affiliation(s)
- O Karray
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - A Saadi
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - M Chakroun
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - H Ayed
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - M Cherif
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - A Bouzouita
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - M R B Slama
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - A Derouiche
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - M Chebil
- Urology department, Charles Nicolle hospital, Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia.
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16
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Karray O, Oueslati A, Chakroun M, Ayed H, Bouzouita A, Cherif M, Ben Slama MR, Derouiche A, Chebil M. Splenogonadal fusion - a rare cause of scrotal swelling: a case report. J Med Case Rep 2018; 12:172. [PMID: 29921313 PMCID: PMC6011191 DOI: 10.1186/s13256-018-1712-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background Splenogonadal fusion is a rare and benign condition. Diagnosis is challenging for clinicians. Despite its indolence, diagnosis is often confirmed after orchidectomy. Surgery is mandatory, particularly to rule out the extremely rare association with malignancy. Case presentation We report a case of splenogonadal fusion in a 38-year-old North African man presenting a palpable scrotal mass. We describe clinical aspects, pathogenic hypothesis, radiological features, as well as surgical management principles. Conclusions Splenogonadal fusion is rarely suspected and diagnosed preoperatively. A diagnosis is made once an ectopic testicular mass is associated with cryptorchidism and suggestive radiological signs. A better knowledge of the clinical and radiological features of splenogonadal fusion provides an opportunity for conservative surgery.
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Affiliation(s)
- O Karray
- Urology department, Charles Nicolle hospital, Tunis, Tunisia.
| | - A Oueslati
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - M Chakroun
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - H Ayed
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - A Bouzouita
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - M Cherif
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - M R Ben Slama
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - A Derouiche
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
| | - M Chebil
- Urology department, Charles Nicolle hospital, Tunis, Tunisia
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17
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Karray O, Boulma R, Abdi A, Ben Miled A, Dhaoui A, Menif N, Bellil K, Khouni H, Chouchen A. Management of a giant retroperitoneal leiomyoma: a case report. J Med Case Rep 2018; 12:81. [PMID: 29576015 PMCID: PMC5868063 DOI: 10.1186/s13256-018-1617-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/14/2018] [Indexed: 11/10/2022] Open
Abstract
Background Leiomyomas are benign tumors observed mainly in adult women. The retroperitoneum is a rare location for leiomyomas; almost 100 cases have been reported. Because retroperitoneal leiomyomas are paucisymptomatic and the tumor size at diagnosis is relatively large, surgical management is challenging. Regular follow-up is required because recurrence and malignant sarcomatous transformation have been described in a few cases. Case presentation We report a case of a 52-year-old North African woman with a 22-cm retroperitoneal leiomyoma. A preoperative embolization was performed 2 days before surgery. The clinical, therapeutic, and evolutive aspects of this rare entity are discussed. Conclusions Despite its benignity, retroperitoneal leiomyoma is a challenging diagnostic, therapeutic, and evolutive condition. Surgeons must consider mainly the tumor’s vascularization. Regular follow-up is mandatory because malignant transformation cannot be excluded.
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Affiliation(s)
- O Karray
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia.
| | - R Boulma
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia
| | - A Abdi
- General Surgery Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - A Ben Miled
- Radiology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - A Dhaoui
- Pathology Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - N Menif
- Radiology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - K Bellil
- Pathology Department, Interior Security Forces Hospital, La Marsa, Tunisia
| | - H Khouni
- Urology Unit, Interior Security Forces Hospital, La Marsa, Tunisia
| | - A Chouchen
- General Surgery Department, Interior Security Forces Hospital, La Marsa, Tunisia
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Abstract
Background Scrotal calcinosis is a rare and benign condition. It usually gives rise to few symptoms, and the impact is mainly functional and aesthetic. It is considered part of dystrophic calcinosis cutis. Surgical management is the only curative approach, and recurrence has been described in few cases. Case presentation We report cases of two North African white patients with operated scrotal calcinosis. We describe the clinical and histological aspects as well as a pathogenic hypothesis and surgical management principles. Conclusions A surgical approach to scrotal calcinosis must consider the aesthetic and functional aspects postoperatively. A complete excision prevents recurrence. Psychological support is required in association with surgery because the lesions are benign and concern an intimate part of the body.
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Affiliation(s)
- O Karray
- Urology Unit, Inrerior security forces hospital, La Marsa, Tunisia.
| | - A Dhaoui
- Pathology Department, Inrerior security forces hospital, La Marsa, Tunisia
| | - R Boulma
- Urology Unit, Inrerior security forces hospital, La Marsa, Tunisia
| | - K Bellil
- Pathology Department, Inrerior security forces hospital, La Marsa, Tunisia
| | - H Khouni
- Urology Unit, Inrerior security forces hospital, La Marsa, Tunisia
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19
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Saadi A, Ayed H, Karray O, Kerkeni W, Bouzouita A, Cherif M, Ben Slama R, Derouiche A, Chebil M. [Rare complication of renal transplantation: Emphysematous pyelonephritis]. Nephrol Ther 2017; 13:479-481. [PMID: 28760516 DOI: 10.1016/j.nephro.2017.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 11/28/2022]
Abstract
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma and peri-renal tissues, characterized by the presence of air within the parenchyma of the urinary tract and peri-renal space. This is a severe complication, which involves the functional prognosis of the kidney and the patient's prognosis. The emphysematous pyelonephritis is a rare complication of renal transplantation. Its gravity is linked particularly to the fragility of immunosuppressed patients. The authors report the case of an emphysematous pyelonephritis having occurred 9 months after transplantation in a patient 58 years. The evolving risks and therapeutic modalities will be outlined and discussed.
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Affiliation(s)
- Ahmed Saadi
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie.
| | - Haroun Ayed
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Omar Karray
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Walid Kerkeni
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Abderrazak Bouzouita
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Mohamed Cherif
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Riadh Ben Slama
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Amine Derouiche
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
| | - Mohamed Chebil
- Urology department, Charles-Nicolle hospital, university of Tunis El Manar, boulevard 9-Avril-1938, 1006 Tunis, Tunisie
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Abstract
Background Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. Case presentation We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed. Conclusions The diagnosis of spontaneous rupture of the common bile duct is a challenge for both radiologist and surgeon. Beyond the difficulty of diagnosis, which requires radiological exploration, management of the subsequent biliary peritonitis involves urgent surgery, life-supporting measures, and close monitoring.
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Affiliation(s)
- Makram Moussa
- Department of General Surgery, Habib Bougatfa Hospital, Bizerte, Tunisia. .,Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Wissem Triki
- Department of General Surgery, Habib Bougatfa Hospital, Bizerte, Tunisia.,Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Omar Karray
- Department of General Surgery, Habib Bougatfa Hospital, Bizerte, Tunisia.,Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ines Marzouk
- Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of Diagnostic and Interventional Imaging, Mongi Slim University Hospital Marsa, La Marsa, Tunisia
| | - Bouchoucha Sami
- Department of General Surgery, Habib Bougatfa Hospital, Bizerte, Tunisia.,Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia
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21
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Saadi A, Ayed H, Karray O, Kerkeni W, Bouzouita A, Cherif M, Slama RB, Derouiche A, Chebil M. [Retroperitoneal cystic lymphangioma: about 5 cases and review of the literature]. Pan Afr Med J 2016; 25:73. [PMID: 28292036 PMCID: PMC5324145 DOI: 10.11604/pamj.2016.25.73.10002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/16/2016] [Indexed: 11/27/2022] Open
Abstract
Le lymphangiome kystique est une tumeur bénigne malformative rare des vaisseaux lymphatiques à localisations diverses. La localisation rétropéritonéale est moins fréquente comparée à celle mésentérique. Sa présentation clinique est polymorphe. Le diagnostic est évoqué par l'imagerie mais il nécessite une confirmation histologique. Le traitement de choix est chirurgical. Notre objectif est d'étudier les manifestations cliniques, les complications, les aspects diagnostiques et thérapeutiques de cette tumeur. Nous rapportons une série de 5 cas de lymphangiomes kystiques rétropéritonéaux (4 femmes et un homme) opérés dans notre service entre les années 2004 et 2014. Leurs dossiers ont été examinés rétrospectivement. Le suivi était basé sur l'examen clinique et l'échographie abdominale. L´âge moyen était de 45 ans. Le suivi moyen était de 32,6 mois. La symptomatologie révélatrice la plus fréquente était les douleurs et/ou une masse abdominale. Le scanner abdominal était l'examen le plus utile au diagnostic. Une exérèse complète était réalisée d'emblée chez quatre patients et elle était différée après cinq ans de surveillance par une échographie annuelle chez un. Dans un cas, on a eu recours à une néphrectomie. Aucune récidive ni complication n´ont été notées chez les 5 patients. le lymphangiome kystique à localisation rétropéritonéale est une affection rare. Sa prise en charge thérapeutique repose sur une exérèse complète, de cas de lésions symptomatiques ou de complications, pour limiter le risque de récidive. Cette dernière peut être différée chez les patients asymptomatiques.
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Affiliation(s)
- Ahmed Saadi
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Haroun Ayed
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Omar Karray
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Walid Kerkeni
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Abderrazak Bouzouita
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Mohamed Cherif
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Riadh Ben Slama
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Amine Derouiche
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
| | - Mohamed Chebil
- Service d'Urologie, Hôpital Charles-Nicolle, Faculté de Médecine de Tunis, Université de Tunis El Manar, boulevard 9-Avril, 1006 Tunis, Tunisie
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Triki W, Baraket O, Moussa M, Karray O, Turki M, Bouchoucha S. Syndrome de la pince mésentérique primitif : cause rare de la sténose digestive haute chez l’adulte. Presse Med 2016; 45:467-8. [DOI: 10.1016/j.lpm.2016.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 01/19/2016] [Accepted: 01/27/2016] [Indexed: 01/13/2023] Open
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Oussama B, Karray O, Ayed K, Moussa M, Triki W, Itaimi A, Bouchoucha S. Factors affecting prognosis after curative surgical treatment of gastric cancer. Clin Cancer Investig J 2016. [DOI: 10.4103/2278-0513.182066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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