Assessing the approach to a thrombosed AV graft.

The patency of the vascular access (VA) is a fight for the attending nephrologist. A retrospective observational study was conducted to compare the success rate of surgical versus endovascular technique percutaneous transluminal angioplasty (PTA) for graft thrombosis treatment. Of 3008 patients, 22.

[Percutaneous thrombus aspiration in renal artery stenosis after renal transplantation].

We describe the case of a patient with chronic renal failure under hemodialysis for five years who, after renal transplantation, developed acute renal failure and hypertension refractory to medical therapy. Given the clinical and imaging (renal ultrasound and computed tomography) suspicion of renal artery graft thrombosis, invasive angiography was performed, which confirmed the diagnosis. The therapeutic approach consisted of percutaneous thrombus aspiration and subsequent balloon angioplasty of the entire artery, followed by stent implantation in a second procedure.

Salvage of malpositioned and malfunctioning peritoneal dialysis catheters by manipulation with a modified Malecot introducer.

Percutaneous peritoneal dialysis (PD) catheter manipulation successfully corrects displacement and contributes to catheter salvage. We describe a new device for the percutaneous treatment of malpositioned PD catheters, the modified Malecot introducer technique, which is an improvement over previous methods because its flexible consistency also allows the manipulation of swan-neck catheters. Twenty-one patients experienced catheter displacement managed by the new introducer: 12 males, average time in PD 13.

[Conservative surgery in pancreatic solid pseudo papillary tumor].

We report the case of a 18-year-old girl having a solid pseudopapillary pancreatic tumor. The patient underwent local enucleation of the tumor located on pancreatic head and remained free of recurrence on the 5th year of follow up. Surgical management is discussed.

[Splenic metastasis in ovary serous adenocarcinoma].

Splenic metastasis is rare, and is usually associated with disseminated malignancy. The primary tumours more frequently related with splenic metastasis are lung, breast, gynaecologic, specially ovary tumours, colon, rectum and melanoma. Isolated secondary splenic disease is rare, but it is described, often associated to ovary cancer.

[Laparoscopic cholecystectomy: day case procedure].

We describe a retrospective analysis of 105 patients who underwent day-case laparoscopic cholecystectomy to evaluate the safety of this procedure. Selection criteria included surgical indications and admission/exclusion criteria for day-case surgery. We analysed: causes of overnight stay and readmission, need of medical or nursing care after discharge, degree of patient satisfaction and insatisfaction reasons.