| Discussion in 'All Categories' started by Amjed - Jul 14th, 2014 8:44 am. | |
Amjed
|
My dear thank you so much for your cooperation , I am the Iraqi doctor who call you this morning about my mother condition,I will present her case to you as following; She is 64 years old lady,just 7 days ago she complained from frank painless haematuria , preceded by generalized weakness ,loss of appetite,loss of weight,depression,pale skin, Then she consult a urosurgeon who ask here to do blood ,urine tests and CT scan and the result was; Blood sugar 92 mg/dl Blood urea 32 mg/100 ml S.creatinine 0.6 S.uric acid 6.3 Pcv 34 WBC 8200 ESR 52 CT scan CT scan of the abdomin ( native and dynamic iv contrast study : Nearly 5.5 by 5 by 4.4 cm well defined cortical right renal soft tissue mass is seen with exophytic growth,central area of break down and no calcification. The mass showed significant enhancement within arterial phase after IV contrast injection with rapid wash out more than normal renal tissue in delayed phases. The mass not extend beyond Gerotas fascia with no major vascular or regional organs invasion ,no regional LAP, but Perinephric evident abnormal vessels and fat stranding are seen with normally functioning kidney. Abnormal intra-renal vascularity are seen goes with AV fistula with presence of upper pole 5 mm stone. Left kidney in size and function. Conclusion :? right renal cell carcinoma Then the decision of the urosurgeon is to do Radical Nephrectomy ,since the patient is known case of Myocarial infarction for 5 years ago,also she is has bronchial asthma ,then the urosurgeon ask to be evaluated by cardiologist to assess her fitness for surgery under GA; The report of cardiologist was as following : Hypertensive,IHD,female Moderate LV systole Dystolic EF = 36% RVSP =73mmhg She has high risk for the operation . My questions are; 1-Is the risk will be the same in your hospital ? 2- what type of anasthesia for this specific case your hospital will do?General anasthesia or spinal? 3-what type of surgery ? Anterior approach or laparoscopic operation? 4- what about the estimated cost in your hospital ? My best regards and wishes Yours Dr. Amjed Aljabri Iraq |
|
re: RenL cell carcinoma
by Dr.J S Chowhan -
Jul 15th, 2014
4:00 pm
#1
|
|
|
Dr.J S Chowhan
|
Dear Dr Amjed Aljabri Your mother is definitely high risk patient because of the H/O Myocardial Infarction. She will require pre operative Stress Thallium scan to see the viable heart muscle. Ideally the patients with boiopsy proven malignant disease should undergo open surgery because retrieval in minimal accesss surgery can lead to seedling of the cancer cells. The surgery will be done under general anasthesia. The estimated cost of this operation will be around USD 8000/ (Eight Thousand US dollars.) Thanks With Regards Dr J S Chowhan |
If you have a surgical concern and can’t reach a doctor right away, or you’re not sure where else to ask a qualified laparoscopic surgeon, you can get our Medical Help through this Forum of World Laparoscopy Hospital which is available 24 hours a day, Just fill-up the form given and within few our the answer of your question will be posted on this forum. Please keep in mind we answer the question only related to laparoscopic surgery. You can also search and browse thousands of answer already posted on this forum
Using Free Medical Advice Related to Laparoscopic Surgery Service, you can send your questions to our Laparoscopic Surgeon and the Doctor will reply within few hour. It’s as if you are having an email exchange with your very own private surgeon! As soon as you post your question, a qualified laparoscopic surgeon will start answering it. Our expert can help you learn more about the treatment and procedure options available to you for different health problems and diseases.They’ll also give you information to discuss with your doctor when deciding what kind of surgical treatment is best for you.
The Doctor will provide you with the all the medical information you need, and will guide you as you choose a course of action, all from the comfort of your home or office. No more sitting in the waiting room for hours just to get some basic information from your laparoscopic surgeon; no more self-diagnosis after reading pages and pages of confusing and contradictory Online information.
World Laparoscopy Hospital gives you the personalized health information you need to decide on the right treatment for you. The information that you provide will be seen by every person for education and information purpose so please not write your real name.
