Urothelial carcinomas of the renal pelvis are rare malignancies presenting commonly in older individuals and are characterised by flank pain,haematuria and palpable mass. Squamous differentiation is a common urothelial carcinoma and is usually associated with factors causing chronicirritation such as renal stone, infection and inflammation. We report a case of a young male patient who was incidentally diagnosed with rightpelvic-ureteric junction obstruction during evaluation for Hodgkin lymphoma. After completion of chemotherapy for Hodgkin lymphoma, thepatient underwent laparoscopic Anderson-Hynes pyeloplasty. The resected adynamic segment part of the pelvic-ureteric junction was sent forhistopathological examination, which showed high-grade urothelial carcinoma with extensive squamous metaplasia. The patient was furthermanaged with laparoscopic radical nephroureterectomy and lymphadenectomy. Our report is the first case of an incidental histologically detectedurothelial carcinoma in a young patient without any radiological mass lesion.
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Objective: Continuous ambulatory peritoneal dialysis is a common treatment mode in patients with end-stage renal disease. Various insertiontechniques of continuous ambulatory peritoneal dialysis catheters have been described in the literature, including percutaneous, open andlaparoscopic techniques, with no consensus about the preferred operative technique.Materials and Methods: Between August 2016 and March 2018, 50 patients undergoing catheter insertion were randomised to insertion by eitherthe open technique or laparoscopy. The demographic, preoperative and postoperative profiles of these patients were recorded and patients werefollowed up for six weeks postoperatively. The Pearson chi-square test was used to compare the results with historical controls. Fisher’s Exact testwas used to assess the incidence of surgical complications. The significance level was set at 0.05.Results: A comparison between the two groups indicated that the only significant difference was in postoperative pain on postoperative evening,lower in the laparoscopic group and statistically significant (p<0.05). There was no statistically significant difference in catheter tip migration,catheter exit-site infection, catheter-associated peritonitis or catheter functional status between the two techniques.Conclusion: The laparoscopic technique does not provide any additional advantage than the open technique in patients undergoing continuousambulatory peritoneal dialysis catheter placement
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