Bøger af Ahmed Saadi

Deeply situated in the retroperitoneum, the adrenal glands are in a complex and dangerous anatomical region because of their vascular relationships and with the neighboring organs. The complications of adrenalectomies are more often related to difficulties of access and exposure than to the glandular exeresis itself. This is reflected in the range of possible complications with overall perioperative complication rates varying between 1.7% and 30.7%. Regardless of the approach chosen (open or laparoscopic, transperitoneal or retroperitoneal), they share the same possible complications: complications related to the topographic anatomy of the adrenal gland that encompass the known complications of open surgery and complications related to the laparoscopic approach. Many of these complications are related to laparoscopic access and are shared with other laparoscopic procedures. Therefore, the rules for preventing complications in laparoscopic surgery also apply to laparoscopic adrenalectomy.

Xanthogranulomatous pyelonephritis represents a chronic pyelonephritis entity of histological diagnosis. Its clinical presentation and radiological aspects are not specific and the discovery of the diagnosis is often made on the anatomopathological examination of the surgical specimen, the only means that allows the diagnosis of GXP to be made with certainty. The focal tumor-like form of GXP is often mistaken for renal cancer, leading to partial or, sometimes, enlarged nephrectomies. The association of a biological inflammatory syndrome with scannographic images of peri-lesional inflammation on a dilated lithiasis kidney should prompt us to evoke the diagnosis and to propose a renal biopsy to confirm the diagnosis and thus avoid a disabling and unnecessary surgery. Primary prevention is ensured by screening subjects at risk and early and adequate management of urinary tract infections, lithiasis and urinary malformations. This entity should also receive more attention in the literature so that it is effectively included among the possible diagnoses in the face of a c